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General NPI Number Information
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NPI Number | 1417459488
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Entity Type | Organization
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Legal Business Name | LAURENCE H. CHURCHILL
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Dates
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Enumeration Date | 03/06/2018
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Last Update Date | 05/15/2019
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Provider Practice Location Address
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Address Line | 1007 SW 1ST AVE
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City | OCALA
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State | FL
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Zip | 34471-0920
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Country | US
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Telephone | 352-732-2745
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Fax | 352-732-8066
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Provider Business Mailing Address
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Address Line | 10 PINE COURSE WAY
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City | OCALA
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State | FL
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Zip | 34472-8301
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Country | US
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Telephone | 386-212-7113
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAURENCE H CHURCHILL
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Credential | DC
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Telephone | 386-212-7113
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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 | CH11293
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License Number State | FL
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