Provider Demographics
NPI:1669480596
Name:REGIONAL CHIROPRACTIC NETWORK INC
Entity Type:Organization
Organization Name:REGIONAL CHIROPRACTIC NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:WOLFSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-629-5956
Mailing Address - Street 1:PO BOX 940968
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32794-0968
Mailing Address - Country:US
Mailing Address - Phone:407-629-5956
Mailing Address - Fax:407-629-8932
Practice Address - Street 1:235 S MAITLAND AVE
Practice Address - Street 2:STE 206
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751
Practice Address - Country:US
Practice Address - Phone:407-629-5956
Practice Address - Fax:407-629-8932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2869111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty