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General NPI Number Information
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NPI Number | 1154643922
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Entity Type | Organization
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Legal Business Name | MADISON CHIROPRACTIC CENTER, LLC
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 10/21/2014
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Provider Practice Location Address
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Address Line | 126 SW SUMATRA AVE UNIT A
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City | MADISON
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State | FL
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Zip | 32340-1458
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Country | US
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Telephone | 850-973-2424
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Fax | 850-973-2684
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Provider Business Mailing Address
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Address Line | 126 SW SUMATRA AVE UNIT A PO BOX 306
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City | MADISON
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State | FL
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Zip | 32340-1458
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Country | US
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Telephone | 850-973-2424
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Fax | 850-973-2684
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Authorized Official
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Title or Position | OWNER / OPERATOR
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Name | STUART N STEIGER
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Credential | DC
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Telephone | 850-973-2424
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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 | 4070
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License Number State | FL
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