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General NPI Number Information
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NPI Number | 1891765988
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Entity Type | Individual
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Provider Name | DAYNE ALAN DEEDS CHIROPRACTOR
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Gender | Male
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 11/12/2019
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Provider Practice Location Address
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Address Line | 1135 S WASHINGTON AVE STE B
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City | TITUSVILLE
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State | FL
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Zip | 32780-8401
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Country | US
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Telephone | 321-408-0440
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Fax | 321-577-0200
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Provider Business Mailing Address
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Address Line | 2708 GARDEN ST
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City | TITUSVILLE
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State | FL
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Zip | 32796-3120
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Country | US
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Telephone | 321-408-0440
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CH8896
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License Number State | FL
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