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General NPI Number Information
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NPI Number | 1528231883
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Entity Type | Organization
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Legal Business Name | HALAJCSIK CHIROPRACTIC CLINIC PA
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Dates
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Enumeration Date | 04/08/2008
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Last Update Date | 08/30/2016
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Provider Practice Location Address
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Address Line | 4350 FOWLER ST STE 1B SUITE 101
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City | FORT MYERS
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State | FL
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Zip | 33901-2616
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Country | US
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Telephone | 239-561-3838
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Fax |
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Provider Business Mailing Address
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Address Line | 4350 FOWLER ST STE 1B SUITE 101
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City | FORT MYERS
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State | FL
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Zip | 33901-2616
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Country | US
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Telephone | 239-561-3838
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. DANIEL SCOTT HALAJCSIK
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Credential | D.C.
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Telephone | 239-561-3838
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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 | CH9473
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License Number State | FL
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