Dr Anthony Michael Fahsholtz, DC | |
106 W North Blvd # 101, Leesburg, FL 34748-5039 | |
(425) 035-2702 | |
Not Available |
Full Name | Dr Anthony Michael Fahsholtz |
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Gender | Male |
Speciality | Chiropractor |
Location | 106 W North Blvd # 101, Leesburg, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063066223 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CH12853 (Florida) | Primary |
Provider Name | Amazing Wellness And Chiropractic |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1710536487 PECOS PAC ID: 1254766066 Enrollment ID: O20200123002058 |
Mailing Address | Practice Location Address |
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Dr Anthony Michael Fahsholtz, DC 2965 Walnut Ct, Leesburg, FL 34748-6494 Ph: (509) 860-3194 | Dr Anthony Michael Fahsholtz, DC 106 W North Blvd # 101, Leesburg, FL 34748-5039 Ph: (425) 035-2702 |
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