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General NPI Number Information
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NPI Number | 1184247967
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Entity Type | Individual
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Provider Name | SUMMER NICHOLE VASSEUR DC
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Gender | Female
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Dates
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Enumeration Date | 05/27/2020
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 608 DECATUR AVE
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City | BROOKSVILLE
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State | FL
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Zip | 34601-3236
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Country | US
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Telephone | 352-796-7201
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Fax |
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Provider Business Mailing Address
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Address Line | 4012 BENCHMARK TRL
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City | BROOKSVILLE
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State | FL
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Zip | 34604-8125
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Country | US
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Telephone | 352-584-0765
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH13126
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License Number State | FL
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