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General NPI Number Information
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NPI Number | 1780971507
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Entity Type | Individual
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Provider Name | MICHAEL MCGURN D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 06/30/2011
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Provider Practice Location Address
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Address Line | 1970 ROCKLEDGE BLVD
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City | ROCKLEDGE
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State | FL
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Zip | 32955-3755
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Country | US
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Telephone | 321-636-3601
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Fax | 321-636-3639
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Provider Business Mailing Address
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Address Line | 1050 SHADY LN
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City | MERRITT ISLAND
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State | FL
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Zip | 32952-6042
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Country | US
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Telephone | 321-750-2628
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3680
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2159
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License Number State | NJ
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