Organization
FIRST CHIRO REHAB CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OCTAVIO MICHAEL VIDAL DC (PRESIDEN/PHYSICIAN)
(239) 674-9437
Entity
Organization
Contact information
Practice address
3507 LEE BLVD STE 207, LEHIGH ACRES, FL 33971-1303
(239) 674-9437
(239) 674-9524
Mailing address
3507 LEE BLVD STE 207, LEHIGH ACRES, FL 33971-1303
(239) 674-9437
(239) 674-9524
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
CH6781
FL
Other
Enumeration date
11/23/2011
Last updated
11/23/2011
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