Healthcare Provider Details

I. General information

NPI: 1639354988
Provider Name (Legal Business Name): WALDRON CHIROPRACTIC HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2008
Last Update Date: 12/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 RYANT BLVD
SEBRING FL
33870-8075
US

IV. Provider business mailing address

13 RYANT BLVD
SEBRING FL
33872-4075
US

V. Phone/Fax

Practice location:
  • Phone: 863-382-4445
  • Fax: 863-382-4447
Mailing address:
  • Phone: 863-382-4445
  • Fax: 863-382-4447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH5915
License Number StateFL

VIII. Authorized Official

Name: DR. DAVID KEATLEY WALDRON
Title or Position: OWNER
Credential: DC
Phone: 863-382-4445