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Organization
SPACE COAST CORPORATE HEALTH SERVICE P A
Active
Organization
SPACE COAST CORPORATE HEALTH SERVICE P A
Active
Other names
SCCHS
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY JE CLOW DC (PRESIDENT)
(321) 725-8778
Entity
Organization
Contact information
Practice address
145 PALM BAY RD NE, STE 120, MELBOURNE, FL 32904-8601
(321) 725-8778
(321) 984-5299
Mailing address
145 PALM BAY RD NE, STE 120, MELBOURNE, FL 32904-8601
(321) 725-8778
(321) 984-5299
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH4422
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34121
BCBS
FL
Enumeration date
08/31/2005
Last updated
08/23/2024
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