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General NPI Number Information
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NPI Number | 1164782553
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Entity Type | Organization
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Legal Business Name | PERDUE CHIROPRACTIC CENTER, LLC
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Dates
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Enumeration Date | 05/21/2012
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 1900 PALM BAY RD NE STE E
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City | PALM BAY
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State | FL
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Zip | 32905-2955
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Country | US
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Telephone | 321-984-5355
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Fax | 321-984-7206
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Provider Business Mailing Address
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Address Line | 1900 PALM BAY RD NE STE E
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City | PALM BAY
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State | FL
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Zip | 32905-2955
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Country | US
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Telephone | 321-984-5355
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Fax | 321-984-7206
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. TAMMY TWOHIG
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Credential | MANAGER
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Telephone | 321-984-5355
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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 | CH6225
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License Number State | FL
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