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General NPI Number Information
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NPI Number | 1982948329
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Entity Type | Organization
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Legal Business Name | M.H.B. LEGACY L.L.C.
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 11/26/2012
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Provider Practice Location Address
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Address Line | 255 W HIGHWAY 50
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City | CLERMONT
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State | FL
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Zip | 34711-3027
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Country | US
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Telephone | 352-394-4615
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Fax | 352-394-7400
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Provider Business Mailing Address
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Address Line | 255 W HIGHWAY 50
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City | CLERMONT
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State | FL
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Zip | 34711-3027
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Country | US
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Telephone | 352-394-4615
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Fax | 352-394-7400
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. LARHONHDA FARMER
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Credential | D.C.
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Telephone | 678-756-4859
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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 | CH10649
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License Number State | FL
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