Provider Demographics
NPI:1306398714
Name:PERDUE, DEVIN (DC)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:
Last Name:PERDUE
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 1:1704 ATLANTIC ST
Mailing Address - Street 2:2C
Mailing Address - City:MELBOURNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32951-2341
Mailing Address - Country:US
Mailing Address - Phone:850-980-9239
Mailing Address - Fax:
Practice Address - Street 1:1101 W HIBISCUS BLVD
Practice Address - Street 2:STE 105
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2700
Practice Address - Country:US
Practice Address - Phone:850-980-9239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11992111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor