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General NPI Number Information
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NPI Number | 1306251293
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Entity Type | Organization
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Legal Business Name | WEST WIND CHIROPRACTIC LLC
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Dates
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Enumeration Date | 06/30/2014
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Last Update Date | 06/30/2014
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Provider Practice Location Address
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Address Line | 14090 METROPOLIS AVE STE 101
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City | FORT MYERS
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State | FL
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Zip | 33912-4450
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Country | US
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Telephone | 239-431-9432
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Fax |
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Provider Business Mailing Address
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Address Line | 14090 METROPOLIS AVE STE 101
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City | FORT MYERS
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State | FL
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Zip | 33912-4450
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Country | US
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Telephone | 239-431-9432
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SEAN KEITH PADGETT
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Credential | DC
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Telephone | 239-431-9432
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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 | CH11238
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License Number State | FL
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