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General NPI Number Information
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NPI Number | 1902499197
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Entity Type | Individual
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Provider Name | DR. PETER WILLIAMS BIRCH
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Gender | Male
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Dates
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Enumeration Date | 02/18/2021
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 6350 GULF OF MEXICO DR STE 103B
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City | LONGBOAT KEY
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State | FL
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Zip | 34228-1501
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Country | US
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Telephone | 941-899-5937
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Fax | 941-383-7742
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Provider Business Mailing Address
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Address Line | PO BOX 8725
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City | LONGBOAT KEY
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State | FL
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Zip | 34228-8725
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Country | US
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Telephone | 941-224-9007
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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 | CH13327
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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 | 13327
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License Number State | FL
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