| |
555 N Byron Butler Pkwy Perry FL 32347-2315 | |
(850) 223-5400 | |
(850) 223-5401 |
Full Name | |
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Speciality | Clinic/Center |
Location | 555 N Byron Butler Pkwy, Perry, Florida |
Authorized Official Name and Position | Karen Tidwell (CLINIC MANAGER) |
Authorized Official Contact | 8502235409 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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555 N Byron Butler Pkwy Perry FL 32347-2315 Ph: (850) 223-5400 | 555 N Byron Butler Pkwy Perry FL 32347-2315 Ph: (850) 223-5400 |
NPI Number | 1457399982 |
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Provider Enumeration Date | 06/04/2006 |
Last Update Date | 11/27/2012 |
Medicare PECOS PAC ID | 5092614503 |
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Medicare Enrollment ID | O20040128000949 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457399982 | NPI | - | NPPES |
10D079975 | Other | FL | CLIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 660124300 (Florida) | Primary |
Perry Chiropractic Clinic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 N Orange St, Perry, FL 32347 Phone: 850-584-7117 Fax: 850-584-7119 | |