Healthcare Provider Details

I. General information

NPI: 1881883825
Provider Name (Legal Business Name): ALLEN C. HOVERSON III DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 11/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 GROVE DR
NAPLES FL
34120-1422
US

IV. Provider business mailing address

15275 COLLIER BLVD STE 201 SUITE 261
NAPLES FL
34119-6750
US

V. Phone/Fax

Practice location:
  • Phone: 239-352-2267
  • Fax: 239-234-6920
Mailing address:
  • Phone: 239-352-2267
  • Fax: 239-234-6920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 9281
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: