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ESTERO FAMILY CHIROPRACTIC LLC NPI 1679826705


NPI Information

NPI: 1679826705
Provider Name: ESTERO FAMILY CHIROPRACTIC LLC
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
21740 S TAMIAMI TRL STE 103
ESTERO, FL
ZIP 33928
Phone: (815) 252-9783
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ESTERO FAMILY CHIROPRACTIC LLC is a chiropractor in Estero, FL. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. ESTERO FAMILY CHIROPRACTIC LLC NPI is 1679826705. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

21740 S TAMIAMI TRL STE 103
ESTERO, FL
ZIP 33928-819
Phone: (815) 252-9783

The provider's authorized official is Lawrence Clifford Wallen .
The authorized official title is Owner/chiropractor and has the following contact phone number (815) 252-9783.

The enumeration date for this NPI number is 10/26/2012 and was last updated on 10/25/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractorCH10733FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GX440AMEDICARE UPINFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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