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NPI Code Detail

MEDICARE: FALLON CHIROPRACTIC SERVICES INC

MEDICARE: FALLON CHIROPRACTIC SERVICES INC
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
1111N00000XChiropractorCH9002FL

General Provider Information

NPI Number : 1740300854
Entity Type Code : Organization
Provider Name (Legal Business Name) : FALLON CHIROPRACTIC SERVICES INC
Provider Business Mailing Address
First Line : 5288 SEMINOLE BLVD
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33708-3356
Country : US
Telephone Number : 727-391-4300
Fax Number :
Provider Business Practice Location Address
First Line : 5288 SEMINOLE BLVD
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33708-3356
Country : US
Telephone Number : 727-391-4300
Fax Number : 727-393-7922
Authorized Official
Title or Position : CLINIC DIRECTOR
Name : DR. SEAN MICHAEL FALLON
Credential : D.C.
Telephone Number : 727-391-4300
Provider Enumeration Date : 03/30/2007
Last Update Date : 12/01/2007

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Directions to “FALLON CHIROPRACTIC SERVICES INC ” Practice Location

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