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General NPI Number Information
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NPI Number | 1912318601
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Entity Type | Organization
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Legal Business Name | UNDERHILL CHIROPRACTIC LLC
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Dates
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Enumeration Date | 05/15/2014
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Last Update Date | 05/15/2014
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Provider Practice Location Address
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Address Line | 401 CANAL ST
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-7009
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Country | US
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Telephone | 386-690-0816
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Fax |
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Provider Business Mailing Address
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Address Line | 314 CITRUS OPEN DR
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-6194
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Country | US
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Telephone | 334-655-8455
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RONALD LINDSEY UNDERHILL III
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Credential | D.C.
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Telephone | 386-690-0816
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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 | CH 10415
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License Number State | FL
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