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General NPI Number Information
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NPI Number | 1548733942
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC CARE LLC
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Dates
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Enumeration Date | 01/08/2019
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 1944 SE PORT ST LUCIE BLVD
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-5510
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Country | US
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Telephone | 772-878-6500
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Fax | 772-878-6501
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Provider Business Mailing Address
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Address Line | 1944 SE PORT ST LUCIE BLVD
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-5510
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Country | US
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Telephone | 772-878-6500
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Fax | 772-878-6501
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Authorized Official
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Title or Position | SOLE MBR
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Name | DR. JAMES MICHAEL SALOMON JR.
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Credential | D.C.
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Telephone | 770-605-4913
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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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