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General NPI Number Information
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NPI Number | 1275414468
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Entity Type | Organization
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Legal Business Name | GONSTEAD CHIROPRACTIC CLINIC OF EAST FLORIDA LLC
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Dates
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Enumeration Date | 09/12/2025
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 1913 N CLYDE MORRIS BLVD STE 110
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-5519
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Country | US
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Telephone | 386-265-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 100 ALVA CIR APT 1107
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-7246
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Country | US
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Telephone | 386-265-0000
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. LINDY BAIRD
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Credential | D.C.
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Telephone | 234-567-0567
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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 |
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License Number State |
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