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Organization
SPACE COAST CHIROPRACTIC INC
Active
Organization
SPACE COAST CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMMIE L COLEY DC (CHIROPRACTOR)
(321) 729-9000
Entity
Organization
Contact information
Practice address
1070 S WICKHAM ROAD, SPACE COAST CHIROPRACTIC INC, WEST MELBOURNE, FL 32904
(321) 729-9000
(321) 722-3997
Mailing address
1070 S WICKHAM ROAD, SPACE COAST CHIROPRACTIC INC, WEST MELBOURNE, FL 32904
(321) 729-9000
(321) 722-3997
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH8196
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1628516000
ACS-DEPARTMENT OF LABOR
FL
Enumeration date
03/22/2007
Last updated
08/22/2020
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