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General NPI Number Information
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NPI Number | 1174270367
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Entity Type | Individual
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Provider Name | CHAD CANFIELD
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Gender | Male
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Dates
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Enumeration Date | 03/07/2022
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 631 OLD MOUNT DORA RD
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City | EUSTIS
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State | FL
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Zip | 32726-7317
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Country | US
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Telephone | 407-402-0201
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Fax | 352-357-8082
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Provider Business Mailing Address
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Address Line | PO BOX 1886
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City | EUSTIS
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State | FL
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Zip | 32727-1886
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Country | US
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Telephone | 407-402-0201
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Fax | 352-357-8082
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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