Healthcare Provider Details

I. General information

NPI: 1730418591
Provider Name (Legal Business Name): JOHN ABENDROTH, D.C., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 03/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SE OCEAN BLVD SUITE 101
STUART FL
34996-3332
US

IV. Provider business mailing address

2100 SE OCEAN BLVD SUITE 101
STUART FL
34996-3332
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-7337
  • Fax: 772-223-7794
Mailing address:
  • Phone: 772-223-7337
  • Fax: 772-223-7794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. CARL JOHN ABENDROTH III
Title or Position: PRESIDENT
Credential: D.C. PA
Phone: 772-223-7337