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General NPI Number Information
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NPI Number | 1902966807
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Entity Type | Organization
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Legal Business Name | MICHAEL STRUBLE, P.A.
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 04/05/2012
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Provider Practice Location Address
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Address Line | 4883 PALM COAST PKWY NW UNIT 4
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City | PALM COAST
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State | FL
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Zip | 32137-3675
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Country | US
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Telephone | 386-445-6565
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Fax | 386-445-4481
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Provider Business Mailing Address
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Address Line | 4883 PALM COAST PKWY NW UNIT 4
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City | PALM COAST
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State | FL
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Zip | 32137-3675
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Country | US
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Telephone | 386-445-6565
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Fax | 386-445-4481
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | MICHAEL DEAN STRUBLE
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Credential | DC
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Telephone | 386-445-6565
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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 |
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License Number State |
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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 | CH8753
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License Number State | FL
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