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NPI Code Detail

MEDICARE: PRIEST CHIROPRACTIC INC

MEDICARE: PRIEST CHIROPRACTIC 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
1111NX0800XOrthopedic ChiropractorCH4353FL

General Provider Information

NPI Number : 1962671776
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIEST CHIROPRACTIC INC
Provider Business Mailing Address
First Line : 2755 N WICKHAM RD STE 104
Second Line :
City : MELBOURNE
State : FL
Zip : 32935-2226
Country : US
Telephone Number : 321-254-3888
Fax Number : 321-254-0097
Provider Business Practice Location Address
First Line : 2755 N WICKHAM RD STE 104
Second Line :
City : MELBOURNE
State : FL
Zip : 32935-2226
Country : US
Telephone Number : 321-254-3888
Fax Number : 321-254-0097
Authorized Official
Title or Position : CEO
Name : DR. GREGORY CHARLES PRIEST
Credential : DC
Telephone Number : 321-254-3888
Provider Enumeration Date : 02/26/2008
Last Update Date : 02/24/2009

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Directions to “PRIEST CHIROPRACTIC INC ” Practice Location

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