Organization
ESTERO FAMILY CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE CLIFFORD WALLEN III DC (OWNER/CHIROPRACTOR)
(815) 252-9783
Entity
Organization
Contact information
Practice address
21740 S TAMIAMI TRL STE 103, ESTERO, FL 33928-2819
(815) 252-9783
Mailing address
21740 S TAMIAMI TRL STE 103, ESTERO, FL 33928-2819
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH10733
FL
Other
Enumeration date
10/26/2012
Last updated
10/25/2016
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