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General NPI Number Information
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NPI Number | 1982988465
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Entity Type | Organization
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Legal Business Name | EAST-WEST CHIROPRACTIC & REHABILITATION
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Dates
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Enumeration Date | 10/03/2011
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Last Update Date | 10/03/2011
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Provider Practice Location Address
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Address Line | 5030 78TH AVE N SUITE 13
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City | PINELLAS PARK
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State | FL
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Zip | 33781-2400
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Country | US
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Telephone | 727-576-6042
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Fax | 727-576-6582
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Provider Business Mailing Address
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Address Line | 5030 78TH AVE N SUITE 13
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City | PINELLAS PARK
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State | FL
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Zip | 33781-2400
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Country | US
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Telephone | 727-576-6042
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Fax | 727-576-6582
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Authorized Official
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Title or Position | PHYSCIAN/OWNER
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Name | DR. MAYUR M RESHAMWALA
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Credential | D.C.
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Telephone | 727-576-6042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | CH9063
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License Number State | FL
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