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General NPI Number Information
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NPI Number | 1992031702
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Entity Type | Organization
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Legal Business Name | FELTS CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 10/29/2009
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Last Update Date | 10/29/2009
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Provider Practice Location Address
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Address Line | 5800 OVERSEAS HWY SUITE 7
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City | MARATHON
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State | FL
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Zip | 33050-2735
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Country | US
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Telephone | 305-743-0039
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Fax | 305-743-0472
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Provider Business Mailing Address
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Address Line | 5800 OVERSEAS HWY SUITE 7
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City | MARATHON
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State | FL
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Zip | 33050-2735
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Country | US
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Telephone | 305-743-0039
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Fax | 305-743-0472
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK R FELTS
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Credential | DC
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Telephone | 305-743-0039
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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 | CH0007071
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License Number State | FL
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