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General NPI Number Information
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NPI Number | 1396489761
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Entity Type | Organization
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Legal Business Name | THOMAS J, NARDELLO, JR., D.C.,LLC DBA BROWN FAMILY CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 04/22/2022
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 674 NE JENSEN BEACH BLVD
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City | JENSEN BEACH
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State | FL
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Zip | 34957-4750
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Country | US
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Telephone | 772-334-0034
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Fax | 772-334-0032
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Provider Business Mailing Address
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Address Line | 674 NE JENSEN BEACH BLVD
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City | JENSEN BEACH
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State | FL
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Zip | 34957-4750
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Country | US
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Telephone | 772-334-0034
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Fax | 772-334-0032
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Authorized Official
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Title or Position | OWNER-MANAGER
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Name | THOMAS JOHN NARDELLO JR.
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Credential | D.C
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Telephone | 203-910-9932
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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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