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General NPI Number Information
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NPI Number | 1912179680
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Entity Type | Organization
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Legal Business Name | EXUM CHIROPRACTIC CLINIC, P.A.
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 02/01/2017
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Provider Practice Location Address
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Address Line | 3541 EDGEWATER DR
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City | ORLANDO
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State | FL
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Zip | 32804-2942
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Country | US
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Telephone | 407-423-0038
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Fax | 407-849-6084
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Provider Business Mailing Address
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Address Line | 3541 EDGEWATER DR
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City | ORLANDO
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State | FL
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Zip | 32804-2942
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Country | US
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Telephone | 407-423-0038
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Fax | 407-849-6084
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT J FRITZ JR.
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Credential | D.C.
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Telephone | 407-423-0038
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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 | CH5270
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License Number State | FL
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