Provider Demographics
NPI:1477270890
Name:EYERLY HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:EYERLY HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:EYERLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-262-0001
Mailing Address - Street 1:502 BOXWOOD LN
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-7902
Mailing Address - Country:US
Mailing Address - Phone:570-262-0001
Mailing Address - Fax:
Practice Address - Street 1:401 VENTURE DR STE C
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-3475
Practice Address - Country:US
Practice Address - Phone:570-262-0001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty