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General NPI Number Information
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NPI Number | 1447637897
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Entity Type | Organization
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Legal Business Name | TAYLOR HOEFFERT DC LLC
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Dates
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Enumeration Date | 05/05/2015
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Last Update Date | 05/05/2015
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Provider Practice Location Address
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Address Line | 211 E INTERNATIONAL SPEEDWAY BLVD SUITE 202
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City | DAYTONA BEACH
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State | FL
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Zip | 32118-4689
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Country | US
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Telephone | 386-212-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 211 E INTERNATIONAL SPEEDWAY BLVD SUITE 202
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City | DAYTONA BEACH
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State | FL
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Zip | 32118-4689
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAYLOR HOEFFERT
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Credential |
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Telephone | 386-212-9100
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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 | CH11498
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License Number State | FL
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