Organization
VILLAGE MEDICAL INJURY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OWEN FRASER MD (PRESIDENT)
(407) 578-9142
Entity
Organization
Contact information
Practice address
510 CR 466, UNIT 104B, LADY LAKE, FL 32159
(407) 578-9142
Mailing address
510 CR 466, UNIT 104B, LADY LAKE, FL 32159
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
12/03/2018
Last updated
12/03/2018
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