Individual
DIVA SOARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
4705 S CLYDE MORRIS BLVD, PORT ORANGE, FL 32129-4103
(386) 763-2718
Mailing address
1092 TURNER LN, ALTAMONTE SPRINGS, FL 32714-2741
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH9233
FL
Other
Enumeration date
06/26/2007
Last updated
07/08/2007
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