Organization
BLUEWATER WELLNESS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LETITIA SMITH (CHIROPRACTOR/ OWNER)
(757) 329-7145
Entity
Organization
Contact information
Practice address
4400 E HIGHWAY 20 STE 207, NICEVILLE, FL 32578-7700
(850) 897-1177
Mailing address
4854 ORLIMAR ST, CRESTVIEW, FL 32536-6413
Taxonomy
Speciality
Code
Description
License number
State
111NP0017X
Pediatric Chiropractor
Primary
—
—
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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