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General NPI Number Information
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NPI Number | 1942392824
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Entity Type | Organization
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Legal Business Name | MARION CHIROPRACTIC ASSOCIATES P A
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 7133 SE MARICAMP RD
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City | OCALA
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State | FL
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Zip | 34472-2103
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Country | US
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Telephone | 352-680-0031
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Fax | 352-680-1288
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Provider Business Mailing Address
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Address Line | 7133 SE MARICAMP RD
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City | OCALA
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State | FL
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Zip | 34472-2103
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Country | US
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Telephone | 352-680-0031
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Fax | 352-680-1288
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Authorized Official
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Title or Position | PRESIDENT CHIROPRACTIC PHYSICIAN
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Name | DR. LESLIE JAMES VAZOULAS
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Credential | D.C
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Telephone | 353-817-3783
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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 | CH8370
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License Number State | FL
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