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General NPI Number Information
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NPI Number | 1801157524
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Entity Type | Organization
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Legal Business Name | TREASURE COAST FAMILY & SPORTS CHIROPRACTIC, PA
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 1635 14TH AVE
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City | VERO BEACH
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State | FL
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Zip | 32960-0435
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Country | US
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Telephone | 772-631-3995
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Fax | 772-631-3995
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Provider Business Mailing Address
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Address Line | 1635 14TH AVE
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City | VERO BEACH
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State | FL
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Zip | 32960-0435
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Country | US
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Telephone | 772-631-3995
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Fax | 772-905-4015
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRET ANDREW WHITE
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Credential | D.C.
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Telephone | 772-631-3995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | CH8776
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License Number State | FL
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