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General NPI Number Information
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NPI Number | 1568766608
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Entity Type | Organization
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Legal Business Name | FAMILY CHIRO - REHAB CENTER, INC.
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 14651 PALM BEACH BLVD SUITE 106A
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City | FORT MYERS
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State | FL
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Zip | 33905-2331
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Country | US
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Telephone | 239-690-2900
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Fax | 239-690-2901
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Provider Business Mailing Address
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Address Line | 14651 PALM BEACH BLVD SUITE 106A
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City | FORT MYERS
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State | FL
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Zip | 33905-2331
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Country | US
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Telephone | 239-690-2900
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Fax | 239-690-2901
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Authorized Official
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Title or Position | DOCTOR
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Name | MARY ANN ZAWADA
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Credential | D.C.
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Telephone | 239-690-2900
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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 | CH7675
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License Number State | FL
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