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Organization
MCKENNEY CHIROPRACTIC CENTER PA
Active
Organization
MCKENNEY CHIROPRACTIC CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA OSBORNE (OFFICE MANAGER)
(352) 245-8955
Entity
Organization
Contact information
Practice address
5608 SE 113TH ST STE A, BELLEVIEW, FL 34420-4069
(352) 245-8955
Mailing address
5608 SE 113TH ST STE A, BELLEVIEW, FL 34420-4069
(352) 245-8955
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH12516
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003069700
—
FL
01
—
39615
BCBS
FL
01
—
617149200
FEDERAL W/C
FL
Enumeration date
07/10/2018
Last updated
07/10/2018
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