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General NPI Number Information
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NPI Number | 1134403108
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Entity Type | Organization
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Legal Business Name | TITUSVILLE CHIROPRACTIC & INJURY CENTER, INC.
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Dates
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Enumeration Date | 10/07/2011
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Last Update Date | 08/13/2018
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Provider Practice Location Address
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Address Line | 850 CENTURY MEDICAL DRIVE
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City | TITUSVILLE
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State | FL
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Zip | 32796
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Country | US
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Telephone | 321-226-1115
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Fax | 321-251-6091
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Provider Business Mailing Address
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Address Line | 850 CENTURY MEDICAL DRIVE
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City | TITUSVILLE
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State | FL
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Zip | 32796
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Country | US
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Telephone | 321-226-1115
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Fax | 321-251-6091
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Authorized Official
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Title or Position | VP
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Name | MRS. JENNIFER H. TRASTELIS
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Credential |
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Telephone | 386-847-7108
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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 | CH9957
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License Number State | FL
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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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