Individual
CHANCE A WUNDERLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1402 LAFAYETTE ST, CAPE CORAL, FL 33904-9763
(239) 540-9888
(239) 540-9889
Mailing address
1402 LAFAYETTE ST, CAPE CORAL, FL 33904-9763
(239) 540-9888
(239) 540-9889
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH7090
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55416
BCBS ID #
FL
01
—
CH7090
STATE LICENSE
FL
Enumeration date
09/15/2006
Last updated
01/23/2008
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