| Wise Chiropractic Pa | |
|
17941 Us Highway 441, Mount Dora, FL 32757-6717 | |
| (352) 516-6820 | |
| Not Available |
| Full Name | Wise Chiropractic Pa |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 17941 Us Highway 441, Mount Dora, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477876472 | NPI | - | NPPES |
| 431001936418001 | Other | FL | CCN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 9678 (Florida) | Primary |
| Provider Name | Jonathan C Wise |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1942446497 PECOS PAC ID: 6103983143 Enrollment ID: I20090319000122 |
| Provider Name | Robert M Bodine |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1194964973 PECOS PAC ID: 7618287699 Enrollment ID: I20151103001269 |
| Mailing Address | Practice Location Address |
|---|---|
| Wise Chiropractic Pa 17941 Us Highway 441, Mount Dora, FL 32757-6717 Ph: (352) 516-6820 | Wise Chiropractic Pa 17941 Us Highway 441, Mount Dora, FL 32757-6717 Ph: (352) 516-6820 |
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