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General NPI Number Information
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NPI Number | 1780317040
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Entity Type | Organization
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Legal Business Name | PALM BAY CHIROPRACTIC AND WELLNESS, PLLC
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Dates
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Enumeration Date | 07/05/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 490 CENTRE LAKE DR NE STE 100A
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City | PALM BAY
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State | FL
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Zip | 32907-1113
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Country | US
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Telephone | 321-499-4608
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Fax | 321-499-4607
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Provider Business Mailing Address
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Address Line | 490 CENTRE LAKE DR NE STE 100A
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City | PALM BAY
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State | FL
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Zip | 32907-1113
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Country | US
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Telephone | 321-499-4608
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Fax | 321-499-4607
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. DAVID M. DURKIN
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Credential | D.C.
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Telephone | 321-499-4608
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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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