Healthcare Provider Details

I. General information

NPI: 1255240891
Provider Name (Legal Business Name): HUNTER EAST DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16022 SW WARFIELD BLVD
INDIANTOWN FL
34956-4400
US

IV. Provider business mailing address

752 SW PINE TREE LN
PALM CITY FL
34990-1426
US

V. Phone/Fax

Practice location:
  • Phone: 772-232-8833
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16117
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: