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General NPI Number Information
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NPI Number | 1033527494
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Entity Type | Organization
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Legal Business Name | 100 PERCENT CHIROPRACTIC TALLAHASSEE ONE, LLC
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Dates
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Enumeration Date | 07/30/2014
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Last Update Date | 12/31/2014
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Provider Practice Location Address
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Address Line | 1950 THOMASVILLE RD SUITE E
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City | TALLAHASSEE
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State | FL
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Zip | 32303-5293
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Country | US
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Telephone | 850-536-6789
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Fax | 850-536-6793
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Provider Business Mailing Address
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Address Line | 1950 THOMASVILLE RD SUITE E
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City | TALLAHASSEE
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State | FL
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Zip | 32303-5293
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Country | US
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Telephone | 850-536-6789
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Fax | 850-536-6793
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. WILLIAM L BEVIS
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Credential | D.C.
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Telephone | 850-509-5067
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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 | CH11224
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License Number State | FL
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