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General NPI Number Information
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NPI Number | 1427341973
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Entity Type | Organization
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Legal Business Name | CANUEL CHIROPRACTIC & MASSAGE, INC
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Dates
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Enumeration Date | 05/17/2011
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Last Update Date | 02/01/2013
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Provider Practice Location Address
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Address Line | 1070 S WICKHAM RD
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City | W MELBOURNE
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State | FL
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Zip | 32904-1653
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Country | US
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Telephone | 321-499-4608
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Fax | 321-499-4607
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Provider Business Mailing Address
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Address Line | 1070 S WICKHAM RD
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City | W MELBOURNE
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State | FL
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Zip | 32904-1653
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Country | US
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Telephone | 321-499-4608
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Fax | 321-499-4607
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Authorized Official
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Title or Position | DIRECTOR CLINIC OPERATIONS
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Name | MS. WENDY CANUEL
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Credential |
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Telephone | 321-499-4608
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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 | CH8309
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License Number State | FL
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