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General NPI Number Information
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NPI Number | 1154664340
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Entity Type | Organization
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Legal Business Name | EDGEWOOD HEALTHCARE AND REHAB CNTR., LLC
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Dates
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Enumeration Date | 04/05/2013
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Last Update Date | 04/05/2013
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Provider Practice Location Address
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Address Line | 5205 S ORANGE AVE # 207
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City | ORLANDO
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State | FL
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Zip | 32809-3068
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Country | US
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Telephone | 407-409-7811
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Fax |
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Provider Business Mailing Address
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Address Line | 5205 S ORANGE AVE #207
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City | ORLANDO
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State | FL
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Zip | 32809-3068
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Country | US
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Telephone | 407-409-7811
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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. H DENNIS HARRISON
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Credential | D..C.
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Telephone | 407-409-7811
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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 | CH 8751
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License Number State | FL
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