Provider Demographics
NPI:1497527055
Name:HEALTHY FAMILY CHIROPRACTIC CLINIC L L C
Entity Type:Organization
Organization Name:HEALTHY FAMILY CHIROPRACTIC CLINIC L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETHE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUEDE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:321-328-0086
Mailing Address - Street 1:5200 BABCOCK ST NE STE 400A
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-4612
Mailing Address - Country:US
Mailing Address - Phone:321-328-0086
Mailing Address - Fax:
Practice Address - Street 1:5200 BABCOCK ST NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-4612
Practice Address - Country:US
Practice Address - Phone:321-328-0086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-26
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty