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General NPI Number Information
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NPI Number | 1174741581
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Entity Type | Organization
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Legal Business Name | COLLIER CHIROPRACTIC AND ACCIDENT REHABILITATION CENTER INC
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 2180 IMMOKALEE RD SUITE 201
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City | NAPLES
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State | FL
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Zip | 34110-1421
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Country | US
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Telephone | 239-594-8995
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Fax | 239-594-9976
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Provider Business Mailing Address
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Address Line | 2180 IMMOKALEE RD SUITE 201
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City | NAPLES
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State | FL
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Zip | 34110-1421
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Country | US
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Telephone | 239-594-8995
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Fax | 239-594-9976
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. RICHARD MAIR
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Credential | DC
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Telephone | 239-594-8995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | CH0008293
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | CH0006936
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License Number State | FL
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