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General NPI Number Information
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NPI Number | 1699838151
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Entity Type | Organization
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Legal Business Name | COLONIAL CHIROPRACTIC ASSOCIATES
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 12/03/2013
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Provider Practice Location Address
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Address Line | 1850 N ALAFAYA TRL BLDG. 1-B
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City | ORLANDO
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State | FL
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Zip | 32826-4745
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Country | US
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Telephone | 407-658-8595
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Fax | 407-658-8573
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Provider Business Mailing Address
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Address Line | 1850 N ALAFAYA TRL BLDG. 1-B
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City | ORLANDO
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State | FL
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Zip | 32826-4745
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Country | US
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Telephone | 407-658-8595
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Fax | 407-658-8573
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. JOSEPH A TERRANOVA
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Credential | D.C.
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Telephone | 407-658-8595
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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 | 30120603746
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License Number State | FL
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