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General NPI Number Information
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NPI Number | 1912504663
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Entity Type | Organization
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Legal Business Name | SEASIDE CHIROPRACTIC HOUSE CALLS
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Dates
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Enumeration Date | 10/06/2020
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 1331 SAXON DR # 147
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32169-3160
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Country | US
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Telephone | 386-269-6680
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Fax |
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Provider Business Mailing Address
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Address Line | 4658 SAXON DR
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32169-4319
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Country | US
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Telephone | 386-269-6680
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. LESLIE NATOLI-HENRY
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Credential | DC
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Telephone | 386-269-6680
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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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