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General NPI Number Information
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NPI Number | 1568617215
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Entity Type | Organization
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Legal Business Name | NADIAN'S CHIROPRACTIC & REHAB CENTER, LLC
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Dates
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Enumeration Date | 11/21/2008
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Last Update Date | 11/21/2008
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Provider Practice Location Address
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Address Line | 1247 N PINE HILLS RD
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City | ORLANDO
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State | FL
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Zip | 32808-6228
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Country | US
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Telephone | 407-293-8285
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 585856
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City | ORLANDO
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State | FL
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Zip | 32858-5856
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Country | US
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Telephone | 407-293-8285
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DIETER GLUCK
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Credential | D.C.
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Telephone | 507-293-8285
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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 | CH3707
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License Number State | FL
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