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Organization
PURE CHIROPRACTIC & NATURAL HEALTH, PA
Active
Organization
PURE CHIROPRACTIC & NATURAL HEALTH, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NEAL WIEDER (PRESIDENT)
(407) 682-4454
Entity
Organization
Contact information
Practice address
200 WAYMONT CT, SUITE 126, UNIT #3, LAKE MARY, FL 32746-3413
(407) 682-4454
(407) 682-3805
Mailing address
200 WAYMONT CT, SUITE 126, UNIT #3, LAKE MARY, FL 32746-3413
(407) 682-4454
(407) 682-3805
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH3063
FL
111NI0013X
Independent Medical Examiner Chiropractor
CH3063
FL
133N00000X
Nutritionist
CH3063
FL
171100000X
Acupuncturist
CH3063
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194299950
STATE OF OHIO WORKER'S COMPENSATION
FL
01
—
88322A
BLUE CROSSS & BLUE SHIELD
FL
01
—
CH3063
STATE OF FLORIDA WORKER'S COMPENSATION
FL
Enumeration date
01/15/2014
Last updated
01/15/2014
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