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General NPI Number Information
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NPI Number | 1043922784
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Entity Type | Organization
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Legal Business Name | CHIROMED INJURY CLINIC LLC
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 4670 CARDINAL WAY STE 301
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City | NAPLES
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State | FL
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Zip | 34112-6665
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Country | US
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Telephone | 239-293-0529
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Fax |
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Provider Business Mailing Address
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Address Line | 741 HICKORY RD
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City | NAPLES
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State | FL
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Zip | 34108-3315
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Country | US
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Telephone | 239-293-0529
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. RICHARD MAIR
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Credential | DC
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Telephone | 239-293-0529
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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 |
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License Number State |
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