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General NPI Number Information
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NPI Number | 1942335187
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Entity Type | Organization
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Legal Business Name | WILLIAM B WATERS D.C.P.A.
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 07/19/2014
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Provider Practice Location Address
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Address Line | 1602 N 9TH AVE
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City | PENSACOLA
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State | FL
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Zip | 32503-5522
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Country | US
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Telephone | 850-435-7777
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Fax | 850-435-3132
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Provider Business Mailing Address
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Address Line | 5513 BAY MEADOWS DR
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City | MILTON
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State | FL
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Zip | 32583-9518
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Country | US
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Telephone | 850-983-7986
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Fax | 850-983-7986
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MRS. DONNA M WATERS
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Credential |
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Telephone | 850-983-7986
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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 | FLCH004090
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License Number State | FL
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