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Organization
WUNDERLICH CHIROPRACTIC CLINIC PA
Active
Organization
WUNDERLICH CHIROPRACTIC CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANCE ALAN WUNDERLICH D.C. (OWNER CHIROPRACTOR)
(239) 540-9888
Entity
Organization
Contact information
Practice address
1402 LAFAYETTE ST, CAPE CORAL, FL 33904-9763
(239) 540-9888
(239) 540-9889
Mailing address
1402 LAFAYETTE ST, CAPE CORAL, FL 33904-9763
(239) 540-9888
(239) 540-9889
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH 7090
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55461
BCBS ID#
FL
01
—
AB985
MEDICARE DOC PROV #
FL
01
—
CH7090
STATE LICENSE
FL
Enumeration date
04/13/2007
Last updated
01/22/2008
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