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General NPI Number Information
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NPI Number | 1831430313
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC CARE OF SW FL PA
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Dates
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Enumeration Date | 03/08/2013
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Last Update Date | 03/08/2013
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Provider Practice Location Address
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Address Line | 3509 FOWLER ST
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City | FORT MYERS
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State | FL
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Zip | 33901-0925
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Country | US
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Telephone | 239-362-0342
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Fax | 239-362-0348
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Provider Business Mailing Address
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Address Line | 3509 FOWLER ST
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City | FORT MYERS
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State | FL
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Zip | 33901-0925
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Country | US
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Telephone | 239-362-0342
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Fax | 239-362-0348
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Authorized Official
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Title or Position | SOLE OWNER
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Name | DR. RUSSELL EUGENE TURNER
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Credential | D.C.
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Telephone | 239-362-0342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 7088
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License Number State | FL
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