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NPI Code Detail

MEDICARE: NAPLES COMMUNITY INJURY CENTER, LLC

MEDICARE: NAPLES COMMUNITY INJURY 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
1111N00000XChiropractorCH0006739FL

General Provider Information

NPI Number : 1205338647
Entity Type Code : Organization
Provider Name (Legal Business Name) : NAPLES COMMUNITY INJURY CENTER, LLC
Provider Business Mailing Address
First Line : 1660 MEDICAL BLVD STE 302
Second Line :
City : NAPLES
State : FL
Zip : 34110-1497
Country : US
Telephone Number : 239-631-5445
Fax Number : 239-631-5458
Provider Business Practice Location Address
First Line : 1660 MEDICAL BLVD STE 302
Second Line :
City : NAPLES
State : FL
Zip : 34110-1497
Country : US
Telephone Number : 239-631-5445
Fax Number : 239-631-5458
Authorized Official
Title or Position : OWNER
Name : DR. JEFFREY M. PECK
Credential : D.C.
Telephone Number : 239-631-5445
Provider Enumeration Date : 03/01/2018
Last Update Date : 03/01/2018

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Directions to “NAPLES COMMUNITY INJURY CENTER, LLC ” Practice Location

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