Healthcare Provider Details

I. General information

NPI: 1730744178
Provider Name (Legal Business Name): CHANCE CHIROPRACTIC REHAB & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2019
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3013 ALOMA AVE
WINTER PARK FL
32792-3701
US

IV. Provider business mailing address

3013 ALOMA AVE
WINTER PARK FL
32792-3701
US

V. Phone/Fax

Practice location:
  • Phone: 407-960-2103
  • Fax: 407-960-6798
Mailing address:
  • Phone: 407-960-2103
  • Fax: 407-960-6798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRETT CHANCE
Title or Position: PRESIDENT
Credential: D. C.
Phone: 407-960-2103