Healthcare Provider Details

I. General information

NPI: 1841663473
Provider Name (Legal Business Name): SEASIDE FAMILY CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2015
Last Update Date: 06/16/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6410 SE FEDERAL HWY
STUART FL
34997-8313
US

IV. Provider business mailing address

5042 SE DEVENWOOD WAY
STUART FL
34997-2155
US

V. Phone/Fax

Practice location:
  • Phone: 772-283-6387
  • Fax:
Mailing address:
  • Phone: 772-283-6387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH11663
License Number StateFL

VIII. Authorized Official

Name: DR. ALICE OAKLEY
Title or Position: OWNER
Credential: D.C.
Phone: 772-600-8159