| Jeter Chiropractic Health Center | |
|
615 Cape Coral Pkwy W Suite #105 Cape Coral FL 33914-6593 | |
| (239) 549-2225 | |
| (239) 549-2265 |
| Full Name | Jeter Chiropractic Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 615 Cape Coral Pkwy W, Cape Coral, Florida |
| Authorized Official Name and Position | Mark E Jeter (PRESIDENT) |
| Authorized Official Contact | 2395492225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeter Chiropractic Health Center 615 Cape Coral Pkwy W Suite #105 Cape Coral FL 33914-6593 Ph: (239) 549-2225 | Jeter Chiropractic Health Center 615 Cape Coral Pkwy W Suite #105 Cape Coral FL 33914-6593 Ph: (239) 549-2225 |
| NPI Number | 1508890575 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 04/30/2008 |
| Medicare PECOS PAC ID | 1456439637 |
|---|---|
| Medicare Enrollment ID | O20080429000533 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508890575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | CH0006411 (Florida) | Primary |
| Provider Name | Mark Edward Jeter |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1023066909 PECOS PAC ID: 6709964992 Enrollment ID: I20080429000560 |
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