Provider Demographics
NPI:1003258336
Name:PRAGLE, ERIC (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:PRAGLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2619 BLAIRSTONE RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-5905
Mailing Address - Country:US
Mailing Address - Phone:850-656-2200
Mailing Address - Fax:850-656-9766
Practice Address - Street 1:2619 BLAIRSTONE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-5905
Practice Address - Country:US
Practice Address - Phone:850-656-2200
Practice Address - Fax:850-656-9766
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor