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General NPI Number Information
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NPI Number | 1457683245
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Entity Type | Individual
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Provider Name | BAMBI R DENAIS D.C.
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Gender | Female
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Dates
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Enumeration Date | 02/04/2010
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Last Update Date | 02/12/2020
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Provider Practice Location Address
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Address Line | 4400 E HIGHWAY 20 STE 207
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City | NICEVILLE
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State | FL
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Zip | 32578-7700
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Country | US
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Telephone | 850-897-1177
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Fax | 850-897-1377
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Provider Business Mailing Address
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Address Line | 4400 E HIGHWAY 20 STE 207
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City | NICEVILLE
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State | FL
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Zip | 32578-7700
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Country | US
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Telephone | 850-897-1177
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Fax | 850-897-1377
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1545
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 111NP0017X
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Taxonomy Name | Pediatric Chiropractor
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License Number | 12307
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License Number State | FL
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