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General NPI Number Information
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NPI Number | 1346456167
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Entity Type | Organization
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Legal Business Name | DOCTOR'S PROFESSIONAL SERVICES CONSULTANTS, INC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 2682 SE WILLOUGHBY BLVD SUITE 201
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City | STUART
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State | FL
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Zip | 34994-4738
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Country | US
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Telephone | 386-615-0801
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Fax | 386-672-4811
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Provider Business Mailing Address
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Address Line | 2682 SE WILLOUGHBY BLVD SUITE 201
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City | STUART
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State | FL
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Zip | 34994-4738
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Country | US
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Telephone | 386-615-0801
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Fax | 386-672-4811
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL S JACKSON
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Credential |
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Telephone | 386-615-0801
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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 | CH3821
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License Number State | FL
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