Provider Demographics
NPI:1780649814
Name:EICHELROTH, WILLIAM JOHN III (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOHN
Last Name:EICHELROTH
Suffix:III
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 1:14100 US HWY ONE
Mailing Address - Street 2:
Mailing Address - City:JUNO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408
Mailing Address - Country:US
Mailing Address - Phone:561-626-6711
Mailing Address - Fax:561-626-6733
Practice Address - Street 1:14100 US HWY ONE
Practice Address - Street 2:
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408
Practice Address - Country:US
Practice Address - Phone:561-626-6711
Practice Address - Fax:561-626-6733
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH002699111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T84675Medicare UPIN
FL88263Medicare ID - Type Unspecified