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General NPI Number Information
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NPI Number | 1750559613
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Entity Type | Organization
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Legal Business Name | POWELL CHIROPRACTOR INC.
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 14212 W NEWBERRY RD
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City | NEWBERRY
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State | FL
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Zip | 32669-2765
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Country | US
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Telephone | 352-331-9229
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Fax | 352-331-9230
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Provider Business Mailing Address
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Address Line | 14212 W NEWBERRY RD
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City | NEWBERRY
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State | FL
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Zip | 32669-2765
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Country | US
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Telephone | 352-331-9229
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Fax | 352-331-9230
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEOFFREY A POWELL
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Credential | D.C.
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Telephone | 352-331-9229
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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 | CH8755
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License Number State | FL
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