Provider Demographics
NPI:1639817802
Name:ELKIN, DAVID AUSTIN CALE (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:AUSTIN CALE
Last Name:ELKIN
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 1:11621 S CLEVELAND AVE STE 80
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-2866
Mailing Address - Country:US
Mailing Address - Phone:239-710-6653
Mailing Address - Fax:
Practice Address - Street 1:11621 S CLEVELAND AVE # UNITE80
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-2866
Practice Address - Country:US
Practice Address - Phone:519-717-4510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14047111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty