Healthcare Provider Details

I. General information

NPI: 1063619385
Provider Name (Legal Business Name): FAMILY CHIROPRACTIC CENTER FOR WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8403 BALM ST
WEEKI WACHEE FL
34607-4419
US

IV. Provider business mailing address

8403 BALM ST
WEEKI WACHEE FL
34607-4419
US

V. Phone/Fax

Practice location:
  • Phone: 352-240-5936
  • Fax: 352-340-5937
Mailing address:
  • Phone: 352-240-5936
  • Fax: 352-340-5937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH9001
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIAN K DAHMER
Title or Position: PRESIDENT
Credential: DC
Phone: 727-862-8571