Healthcare Provider Details

I. General information

NPI: 1174047609
Provider Name (Legal Business Name): MADISON CHIROTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2017
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 SW SUMATRA AVE UNIT C
MADISON FL
32340-1458
US

IV. Provider business mailing address

126 SW SUMATRA AVE UNIT C
MADISON FL
32340-1458
US

V. Phone/Fax

Practice location:
  • Phone: 850-253-2326
  • Fax: 850-253-2381
Mailing address:
  • Phone: 850-253-2326
  • Fax: 850-253-2381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH12200
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. JOSEPH MURRAY HERRING
Title or Position: PROVIDER/OWNER
Credential: DC
Phone: 850-253-2326