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General NPI Number Information
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NPI Number | 1629343801
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Entity Type | Organization
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Legal Business Name | STUART CHIROPRACTIC CENTER PA
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Dates
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Enumeration Date | 03/20/2012
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Last Update Date | 03/20/2012
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Provider Practice Location Address
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Address Line | 2225 S KANNER HWY
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City | STUART
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State | FL
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Zip | 34994-4619
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Country | US
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Telephone | 772-287-0122
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Fax | 772-288-0160
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Provider Business Mailing Address
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Address Line | 2225 S KANNER HWY
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City | STUART
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State | FL
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Zip | 34994-4619
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Country | US
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Telephone | 772-287-0122
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Fax | 772-288-0160
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Authorized Official
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Title or Position | D.C.
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Name | DR. DOUGLAS M RINEHART
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Credential | D.C.
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Telephone | 772-287-0122
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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 | 4394
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License Number State | FL
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