MEDICARE: CHIROPRACTIC CARE OF SW FL PA

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	261Q00000X	Clinic/Center	7088	FL

General Provider Information

NPI Number	:	1831430313
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC CARE OF SW FL PA

Provider Business Mailing Address
First Line	:	3509 FOWLER ST
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-0925
Country	:	US
Telephone Number	:	239-362-0342
Fax Number	:	239-362-0348

Provider Business Practice Location Address
First Line	:	3509 FOWLER ST
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-0925
Country	:	US
Telephone Number	:	239-362-0342
Fax Number	:	239-362-0348

Authorized Official
Title or Position	:	SOLE OWNER
Name	:	DR. RUSSELL EUGENE TURNER
Credential	:	D.C.
Telephone Number	:	239-362-0342

Provider Enumeration Date	:	03/08/2013
Last Update Date	:	03/08/2013

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