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General NPI Number Information
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NPI Number | 1063533438
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Entity Type | Organization
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Legal Business Name | JOINT MANEUVERS CHIROPRACTIC CENTRE PA
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 4797 OLD CANOE CREEK RD
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City | SAINT CLOUD
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State | FL
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Zip | 34769-1400
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Country | US
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Telephone | 407-498-0222
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Fax | 407-892-0800
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Provider Business Mailing Address
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Address Line | 4797 OLD CANOE CREEK RD
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City | SAINT CLOUD
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State | FL
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Zip | 34769-1400
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Country | US
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Telephone | 407-498-0222
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Fax | 407-892-0800
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRETT ELIZABETH PETTY
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Credential | D.C.
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Telephone | 407-498-0222
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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 | CH8130
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License Number State | FL
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