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General NPI Number Information
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NPI Number | 1346402260
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Entity Type | Organization
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Legal Business Name | ABEGWEIT CHIROPRACTIC CENTER LLC
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 245 BELLAGIO CIR
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City | SANFORD
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State | FL
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Zip | 32771-5001
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Country | US
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Telephone | 407-242-3301
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Fax | 407-358-5425
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Provider Business Mailing Address
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Address Line | 1094 OUTLOOK DR
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City | DELTONA
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State | FL
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Zip | 32725-8329
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Country | US
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Telephone | 407-421-4554
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. KATHRYN SHAW
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Credential | PH.D., D.C.
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Telephone | 407-421-4554
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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 | CH9554
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License Number State | FL
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