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General NPI Number Information
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NPI Number | 1093482580
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Entity Type | Organization
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Legal Business Name | M&M CHIROPRACTIC AND WELLNESS, LLC
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Dates
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Enumeration Date | 08/24/2021
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 14261 S TAMIAMI TRL STE 4
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City | FORT MYERS
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State | FL
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Zip | 33912-1912
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Country | US
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Telephone | 239-935-7850
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Fax |
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Provider Business Mailing Address
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Address Line | 14261 S TAMIAMI TRL STE 4
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City | FORT MYERS
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State | FL
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Zip | 33912-1912
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MONICA HUDSON
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Credential | DC
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Telephone | 847-212-1883
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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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