Organization
EVANS CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD BLUM D.C. (OWNER)
(954) 441-7100
Entity
Organization
Contact information
Practice address
3632 EVANS AVE, FORT MYERS, FL 33901-8314
(239) 275-7246
Mailing address
1910 NW 120TH TER, PEMBROKE PINES, FL 33026-1944
(954) 441-7100
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
CH6210
FL
261QR0400X
Rehabilitation Clinic/Center
CH6210
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
380104700
—
FL
Enumeration date
07/13/2009
Last updated
07/13/2009
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