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NPI Code Detail

MEDICARE: KEYS SPINAL DECOMPRESSION OF KEY WEST LLC

MEDICARE: KEYS SPINAL DECOMPRESSION OF KEY WEST 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
1111N00000XChiropractorCH9362AL

General Provider Information

NPI Number : 1245412139
Entity Type Code : Organization
Provider Name (Legal Business Name) : KEYS SPINAL DECOMPRESSION OF KEY WEST LLC
Provider Business Mailing Address
First Line : 5800 OVERSEAS HWY
Second Line : SUITE 7
City : MARATHON
State : FL
Zip : 33050
Country : US
Telephone Number : 305-743-0039
Fax Number :
Provider Business Practice Location Address
First Line : 3712 N ROOSEVELT BLVD
Second Line :
City : KEY WEST
State : FL
Zip : 33040-4533
Country : US
Telephone Number : 305-295-9755
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MARK R FELTS
Credential : D.C.
Telephone Number : 305-743-0039
Provider Enumeration Date : 12/03/2007
Last Update Date : 12/03/2007

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Directions to “KEYS SPINAL DECOMPRESSION OF KEY WEST LLC ” Practice Location

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