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General NPI Number Information
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NPI Number | 1023499662
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Entity Type | Organization
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Legal Business Name | SUPERIOR HEALTHCARE AND PHYSICAL MEDICINE OF NAVARRE INC
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Dates
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Enumeration Date | 06/09/2015
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Last Update Date | 09/10/2015
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Provider Practice Location Address
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Address Line | 1796 NAVARRE SOUND CIRCLE
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City | NAVARRE
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State | FL
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Zip | 32566
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Country | US
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Telephone | 850-936-8664
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Fax | 850-936-4229
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Provider Business Mailing Address
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Address Line | 2542 EDGEWOOD DR
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City | NAVARRE
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State | FL
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Zip | 32566-8257
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Country | US
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Telephone | 850-936-8664
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Fax | 850-936-4229
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. BRETT HENRY BAIRD
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Credential | D.C.
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Telephone | 850-936-8664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH7459
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME73433
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License Number State | FL
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