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General NPI Number Information
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NPI Number | 1114103421
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Entity Type | Organization
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Legal Business Name | CREIGHTON CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 09/04/2012
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Provider Practice Location Address
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Address Line | 2110 CREIGHTON RD
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City | PENSACOLA
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State | FL
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Zip | 32504-7218
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Country | US
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Telephone | 850-473-8080
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Fax | 850-473-8816
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Provider Business Mailing Address
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Address Line | 2110 CREIGHTON RD
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City | PENSACOLA
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State | FL
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Zip | 32504-7218
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Country | US
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Telephone | 850-473-8080
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Fax | 850-473-8816
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Authorized Official
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Title or Position | CHIROPRACTIC PYHSICIAN
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Name | DR. MARIA R SANGILLO
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Credential | D.O.
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Telephone | 850-473-8080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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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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