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Organization
OVERLEA-FULLERTON CHIROPRACTIC CENTER PC
Active
Organization
OVERLEA-FULLERTON CHIROPRACTIC CENTER PC
Active
Other names
Augustine Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN J AUGUSTINE (CHIROPRACTIC PHYSICIAN)
(813) 994-6008
Entity
Organization
Contact information
Practice address
5317 VILLAGE MARKET DRIVE, WESLEY CHAPEL, FL 33544
(813) 994-6008
(813) 994-3063
Mailing address
5317 VILLAGE MARKET DRIVE, WESLEY CHAPEL, FL 33544
(813) 994-6008
(813) 994-3063
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH006174
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
271773
WELLCARE PRVD#
FL
01
—
295986
AVMED PRVD#
FL
05
—
381806300
—
FL
01
—
593466707
CHIRO ALLIANCE #
FL
01
—
89273
BCBS PRVD#
FL
01
—
CH006174
STATE LICENSE #
FL
Enumeration date
04/19/2007
Last updated
10/20/2010
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