Provider Demographics
NPI:1205948536
Name:WALDRON, DAVID K (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:WALDRON
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 1:13 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:33872-4075
Practice Address - Country:US
Practice Address - Phone:863-382-4445
Practice Address - Fax:863-382-4447
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5915111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT79158Medicare UPIN
FL22537Medicare ID - Type Unspecified