MEDICARE: JAMES C. HERNDON JR. DC

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	CH5763	FL

General Provider Information

NPI Number	:	1346254067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES C. HERNDON JR. DC

Provider Business Mailing Address
First Line	:	7575 DR PHILLIPS BLVD., #110
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7221
Country	:	US
Telephone Number	:	407-345-0508
Fax Number	:	407-345-0509

Provider Business Practice Location Address
First Line	:	7575 DR PHILLIPS BLVD., #110
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7221
Country	:	US
Telephone Number	:	407-345-0508
Fax Number	:	407-345-0509

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	12/11/2015

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