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General NPI Number Information
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NPI Number | 1578727004
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Entity Type | Organization
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Legal Business Name | JOHN WILLIAM KURPA DC PA
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Dates
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Enumeration Date | 07/14/2008
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 4261 LAFAYETTE ST
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City | MARIANNA
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State | FL
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Zip | 32446-8235
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Country | US
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Telephone | 850-482-3696
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Fax |
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Provider Business Mailing Address
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Address Line | 6664 OLD SPANISH TRL
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City | GRAND RIDGE
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State | FL
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Zip | 32442-3952
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Country | US
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Telephone | 850-592-9126
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN WILLIAM KURPA
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Credential | D.C., P.A.
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Telephone | 850-482-3696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | CH0003672
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License Number State | FL
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