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General NPI Number Information
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NPI Number | 1053619759
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Entity Type | Organization
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Legal Business Name | DAVIE HEALTH & WELLNESS CENTER INC.
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 2924 DAVIE RD SUITE 101
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City | DAVIE
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State | FL
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Zip | 33314-1602
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Country | US
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Telephone | 954-689-8915
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Fax | 954-689-8925
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Provider Business Mailing Address
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Address Line | 2924 DAVIE RD SUITE 101
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City | DAVIE
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State | FL
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Zip | 33314-1602
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Country | US
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Telephone | 954-689-8915
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Fax | 954-689-8925
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DAVID KIDD
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Credential |
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Telephone | 954-689-8915
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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 | CH7050
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License Number State | FL
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