MEDICARE: RIVER CITY CHIROPRACTIC AND INJURY

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	:	1851993620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVER CITY CHIROPRACTIC AND INJURY

Provider Business Mailing Address
First Line	:	155 S CHARLES RICHARD BEALL BLVD STE B
Second Line	:
City	:	DEBARY
State	:	FL
Zip	:	32713-3268
Country	:	US
Telephone Number	:	386-320-0058
Fax Number	:	386-516-6921

Provider Business Practice Location Address
First Line	:	155 S CHARLES RICHARD BEALL BLVD STE B
Second Line	:
City	:	DEBARY
State	:	FL
Zip	:	32713-3268
Country	:	US
Telephone Number	:	386-320-0058
Fax Number	:	386-516-6921

Authorized Official
Title or Position	:	CHIROPRACTOR/OWNER
Name	:	DR. SETH JAMES BOWDEN
Credential	:	DC
Telephone Number	:	386-320-0058

Provider Enumeration Date	:	11/16/2020
Last Update Date	:	11/16/2020

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Directions to “RIVER CITY CHIROPRACTIC AND INJURY ” Practice Location

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