Provider Demographics
NPI:1750426896
Name:EMIL CHIROPRACTIC LLC
Entity type:Organization
Organization Name:EMIL CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:NARDONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-312-3445
Mailing Address - Street 1:2146 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-4647
Mailing Address - Country:US
Mailing Address - Phone:304-312-3445
Mailing Address - Fax:913-513-4007
Practice Address - Street 1:2146 58TH AVE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-4647
Practice Address - Country:US
Practice Address - Phone:304-312-3445
Practice Address - Fax:913-513-4007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3031111NR0400X
WV736111NR0400X
111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV2203003001Medicaid
WV9325271Medicare ID - Type Unspecified
WV6250910001Medicare NSC
WV2203003001Medicaid