Todd Werner Gignac, DC | |
2255 Crescent Dr, Mount Dora, FL 32757-4708 | |
(352) 720-3672 | |
Not Available |
Full Name | Todd Werner Gignac |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 2255 Crescent Dr, Mount Dora, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548322944 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CH13189 (Florida) | Primary |
Provider Name | Romans 12 Two Pllc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1487242137 PECOS PAC ID: 3678988466 Enrollment ID: O20210208002038 |
Mailing Address | Practice Location Address |
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Todd Werner Gignac, DC 2255 Crescent Dr, Mount Dora, FL 32757-4708 Ph: (352) 720-3672 | Todd Werner Gignac, DC 2255 Crescent Dr, Mount Dora, FL 32757-4708 Ph: (352) 720-3672 |
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