Provider Demographics
NPI:1639354988
Name:WALDRON CHIROPRACTIC HEALTH CENTER
Entity Type:Organization
Organization Name:WALDRON CHIROPRACTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:KEATLEY
Authorized Official - Last Name:WALDRON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:863-382-4445
Mailing Address - Street 1:13 RYANT BLVD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-4075
Mailing Address - Country:US
Mailing Address - Phone:863-382-4445
Mailing Address - Fax:863-382-4447
Practice Address - Street 1:13 RYANT BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-8075
Practice Address - Country:US
Practice Address - Phone:863-382-4445
Practice Address - Fax:863-382-4447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5915111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22537OtherMEDICARE ID NUMNER