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General NPI Number Information
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NPI Number | 1962931741
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Entity Type | Organization
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Legal Business Name | TERRAPIN CHIROPRACTIC INC
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 06/06/2017
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Provider Practice Location Address
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Address Line | 13861 FOLKESTONE CIR APT D
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City | WELLINGTON
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State | FL
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Zip | 33414-7829
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Country | US
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Telephone | 585-576-7890
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Fax | 585-576-7890
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Provider Business Mailing Address
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Address Line | 13861 FOLKESTONE CIR APT D
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City | WELLINGTON
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State | FL
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Zip | 33414-7829
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Country | US
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Telephone | 585-576-7890
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHELLEY MOORE
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Credential | DC
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Telephone | 585-576-7890
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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 | 012687
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH11533
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License Number State | FL
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