MEDICARE: MCBRIDE WELLNESS CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1154044592
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCBRIDE WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	127 N. GARDEN AVE.
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33755-4119
Country	:	US
Telephone Number	:	727-977-9005
Fax Number	:	727-499-2798

Provider Business Practice Location Address
First Line	:	127 N. GARDEN AVE.
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33755-4119
Country	:	US
Telephone Number	:	727-977-9005
Fax Number	:	727-499-2798

Authorized Official
Title or Position	:	DOCTOR
Name	:	RICHARD WILLIAM MCBRIDE
Credential	:	DC
Telephone Number	:	727-250-9612

Provider Enumeration Date	:	09/21/2022
Last Update Date	:	10/27/2022

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Directions to “MCBRIDE WELLNESS CENTER LLC ” Practice Location

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