=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497501811
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MV CHIROPRACTIC CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2024
-----------------------------------------------------
Last Update Date | 04/26/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 333 TAMIAMI TRL S STE 386
-----------------------------------------------------
City | VENICE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34285-2442
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-484-0008
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 333 TAMIAMI TRL S STE 386
-----------------------------------------------------
City | VENICE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34285-2442
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-484-0008
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MICHAEL SPINELLI
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 732-773-8543
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------