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General NPI Number Information
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NPI Number | 1891005369
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE CHIROPRACTIC OF ORMOND, INC
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 02/18/2012
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Provider Practice Location Address
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Address Line | 800 STERTHAUS DR SUITE A
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5132
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Country | US
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Telephone | 386-310-7246
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Fax | 386-310-4952
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Provider Business Mailing Address
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Address Line | 800 STERTHAUS DR SUITE A
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5132
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Country | US
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Telephone | 386-310-7246
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Fax | 386-310-4952
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRAD TEPPER
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Credential | DC
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Telephone | 386-310-7246
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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 | CH10046
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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 | CH10229
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH8484
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License Number State | FL
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