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Organization
REGATTA CHIROPRACTIC AND LASER CENTER INC
Active
Organization
REGATTA CHIROPRACTIC AND LASER CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAWNA HOGAN (CHIROPRACTOR)
(850) 748-6102
Entity
Organization
Contact information
Practice address
4481 LEGENDARY DR, SUITE 150, DESTIN, FL 32541-5381
(850) 424-7856
Mailing address
5953 COMMERCE RD, MILTON, FL 32583-2320
(850) 424-7856
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH 8365
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2631473
UNITED HEALTHCARE
FL
Enumeration date
08/15/2012
Last updated
11/26/2012
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