MEDICARE: EAST COAST FAMILY CHIROPRACTIC PLLC

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	:	1366170771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST COAST FAMILY CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	4220 VALLEY RIDGE BLVD STE 106
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32081-5173
Country	:	US
Telephone Number	:	904-217-0361
Fax Number	:

Provider Business Practice Location Address
First Line	:	4220 VALLEY RIDGE BLVD STE 106
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32081-5173
Country	:	US
Telephone Number	:	904-217-0361
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER/OWNER/AO
Name	:	DR. MORGAN M LINDER
Credential	:	DC
Telephone Number	:	308-830-3440

Provider Enumeration Date	:	08/12/2022
Last Update Date	:	12/21/2023

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