# BREVARD WELLNESS CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Space Coast Wellness Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689059891
- **Authorized official:** DR. CHRISTOPHER BICKFORD OMD, LAC (PRESIDENT)
- **Authorized official phone:** (321) 610-8935

## Contact information

- **Practice address:** 466 N HARBOR CITY BLVD, MELBOURNE, FL 32935-6858
- **Practice address phone:** (321) 610-8935
- **Mailing address:** 436 BAHIA CT NW, PALM BAY, FL 32907-8700
- **Mailing address phone:** (321) 610-8935

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AP855 | FL | Yes |

## Other

- **Enumeration date:** 07/29/2015
- **Last updated:** 07/29/2015