Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 402 E Ash St, Perry, Florida |
Authorized Official Name and Position | Sara Grambling (ADMINISTRATOR) |
Authorized Official Contact | 8505840609 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
333 N Byron Butler Pkwy Perry FL 32347-2300 Ph: (850) 584-0609 | 402 E Ash St Perry FL 32347-2105 Ph: (850) 584-0600 |
NPI Number | 1790728657 |
---|---|
Provider Enumeration Date | 06/14/2006 |
Last Update Date | 06/20/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790728657 | NPI | - | NPPES |
660138300 | Medicaid | FL | |
10D0961933 | Other | CLIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 660138300 (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 | |