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General NPI Number Information
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NPI Number | 1750695045
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Entity Type | Organization
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Legal Business Name | RICHARD A SHELDON DC
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Dates
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Enumeration Date | 07/29/2010
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 350D RACETRACK RD NW
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-1699
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Country | US
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Telephone | 850-863-1920
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Fax | 850-864-5961
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Provider Business Mailing Address
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Address Line | 350D RACETRACK RD NW
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-1699
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Country | US
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Telephone | 850-863-1920
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Fax | 850-864-5961
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD A SHELDON
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Credential | D.C.
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Telephone | 850-863-1920
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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 | CH2979
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License Number State | FL
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