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Organization
WIDOM CHIROPRACTIC OFFICES PA
Active
Organization
WIDOM CHIROPRACTIC OFFICES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAVIN JAY WIDOM DC (OWNER)
(239) 263-3332
Entity
Organization
Contact information
Practice address
5385 PARK CENTRAL CT, NAPLES, FL 34109-5932
(239) 596-9050
Mailing address
5385 PARK CENTRAL CT, NAPLES, FL 34109-5932
(239) 596-9050
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH 6230
FL
Other
Enumeration date
04/19/2012
Last updated
10/22/2012
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