Healthcare Provider Details

I. General information

NPI: 1407295041
Provider Name (Legal Business Name): RICK ALLAN MEANS II D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 06/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 PONDELLA RD
N FT MYERS FL
33903-3846
US

IV. Provider business mailing address

150 PONDELLA RD
N FT MYERS FL
33903-3846
US

V. Phone/Fax

Practice location:
  • Phone: 239-560-9766
  • Fax: 239-997-2285
Mailing address:
  • Phone: 239-560-9766
  • Fax: 239-997-2285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 10916
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: