Provider Demographics
NPI:1831978592
Name:PEIL, NICHOLAS (DC)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:PEIL
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 1:1 HARGROVE GRADE STE 1H
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-5116
Mailing Address - Country:US
Mailing Address - Phone:386-287-0839
Mailing Address - Fax:
Practice Address - Street 1:1 HARGROVE GRADE STE 1H
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-5116
Practice Address - Country:US
Practice Address - Phone:386-287-0839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14661111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor