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General NPI Number Information
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NPI Number | 1487931424
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Entity Type | Organization
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Legal Business Name | HUMBLE CHIROPRACTIC INC
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 8695 COLLEGE PKWY STE 1270
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City | FORT MYERS
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State | FL
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Zip | 33919-5826
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Country | US
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Telephone | 239-214-8578
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Fax | 888-409-0210
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Provider Business Mailing Address
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Address Line | PO BOX 152016
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City | CAPE CORAL
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State | FL
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Zip | 33915-2016
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Country | US
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Telephone | 239-214-8578
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Fax | 888-409-0210
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFERY HUMBLE
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Credential |
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Telephone | 239-214-8578
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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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