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General NPI Number Information
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NPI Number | 1811425002
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Entity Type | Organization
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Legal Business Name | CRESTVIEW HEALTH AND WELLNESS CENTER LLC
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Dates
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Enumeration Date | 06/01/2017
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 596 N FERDON BLVD
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City | CRESTVIEW
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State | FL
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Zip | 32536-2753
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Country | US
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Telephone | 850-306-3268
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Fax | 850-398-5029
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Provider Business Mailing Address
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Address Line | 596 N FERDON BLVD
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City | CRESTVIEW
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State | FL
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Zip | 32536-2753
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Country | US
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Telephone | 850-478-1312
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Fax | 850-474-9060
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID SCOTT RAWSON
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Credential | DC
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Telephone | 850-306-3268
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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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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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