Healthcare Provider Details

I. General information

NPI: 1508405812
Provider Name (Legal Business Name): DJURIC CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2020
Last Update Date: 01/03/2020
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12960 LILLIAN HWY
PENSACOLA FL
32506-8423
US

IV. Provider business mailing address

12960 LILLIAN HWY
PENSACOLA FL
32506-8423
US

V. Phone/Fax

Practice location:
  • Phone: 850-741-4389
  • Fax:
Mailing address:
  • Phone: 850-741-4389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. VLADIMIR DJURIC
Title or Position: OWNER
Credential: DC
Phone: 850-712-0525