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General NPI Number Information
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NPI Number | 1376968412
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Entity Type | Organization
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Legal Business Name | JAMES C HERNDON JR DC P A
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Dates
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Enumeration Date | 02/26/2014
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 7575 DR PHILLIPS BLVD STE 110
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City | ORLANDO
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State | FL
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Zip | 32819-7221
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Country | US
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Telephone | 407-345-0508
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Fax | 407-345-0509
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Provider Business Mailing Address
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Address Line | 7575 DR PHILLIPS BLVD STE 110
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City | ORLANDO
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State | FL
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Zip | 32819-7221
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Country | US
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Telephone | 407-345-0508
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Fax | 407-345-0509
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Authorized Official
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Title or Position | OWNER
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Name | JAMES C. HERNDON JR.
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Credential | D.C.
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Telephone | 407-345-0508
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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 | CH 5763
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License Number State | FL
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