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General NPI Number Information
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NPI Number | 1528100443
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Entity Type | Organization
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Legal Business Name | MCKENNEY CHIROPRACTIC CENTER PA
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 5608 SE 113TH ST SUITE A
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City | BELLEVIEW
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State | FL
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Zip | 34420-4038
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Country | US
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Telephone | 352-245-8955
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Fax | 352-245-9156
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Provider Business Mailing Address
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Address Line | 5608 SE 113TH ST SUITE A
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City | BELLEVIEW
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State | FL
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Zip | 34420-4038
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Country | US
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Telephone | 352-245-8955
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Fax | 352-245-9156
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Authorized Official
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Title or Position | CEO
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Name | DR. CHRIS W MCKENNEY
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Credential | DC
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Telephone | 352-245-8955
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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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