Healthcare Provider Details

I. General information

NPI: 1497143093
Provider Name (Legal Business Name): RICK A MEANS II DC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2015
Last Update Date: 01/05/2015
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: 239-997-5007
  • Fax: 239-997-2285
Mailing address:
  • Phone: 239-997-5007
  • Fax: 239-997-2285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH10916
License Number StateFL

VIII. Authorized Official

Name: DR. RICK A MEANS II
Title or Position: OWNER
Credential: D.C.
Phone: 239-997-5007