Organization
ETHEREDGE CHIROPRACTIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD KIM ETHEREDGE DC (OWNER/CHIRPRACTOR)
(352) 365-1191
Entity
Organization
Contact information
Practice address
3261 US HWY 27/441, FRUITLAND PARK, FL 34731
(352) 365-1191
(352) 365-0330
Mailing address
3261 US HWY 27/441, FRUITLAND PARK, FL 34731
(352) 365-1191
(352) 365-0330
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
—
—
Other
Enumeration date
10/11/2006
Last updated
08/21/2007
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