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General NPI Number Information
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NPI Number | 1841577871
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Entity Type | Organization
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Legal Business Name | ACCIDENT RECOVERY CENTERS
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 550 UNIVERSITY BLVD, STE 104
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City | PORT ST. LUCIE
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State | FL
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Zip | 34986
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Country | US
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Telephone | 561-729-7092
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16836
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City | WEST PALM BEACH
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State | FL
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Zip | 33416-6836
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RYAN GRAND
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Credential | D.O.
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Telephone | 561-729-7092
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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 | CH8588
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License Number State | FL
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