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General NPI Number Information
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NPI Number | 1639724917
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Entity Type | Organization
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Legal Business Name | EMBRACE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 1006 VIRGINIA AVE
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City | FORT PIERCE
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State | FL
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Zip | 34982-3522
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Country | US
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Telephone | 772-466-5600
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Fax | 772-466-1572
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Provider Business Mailing Address
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Address Line | 1006 VIRGINIA AVE
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City | FORT PIERCE
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State | FL
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Zip | 34982-3522
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Country | US
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Telephone | 772-466-5600
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Fax | 772-466-1572
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAYMOND WALTER DONER
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Credential | DC
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Telephone | 772-466-5600
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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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