Organization
MUA OF CHARLOTTE COUNTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN M. VAN NOSTRAND DC (AUTHORIZED OFFICIAL)
(941) 625-9800
Entity
Organization
Contact information
Practice address
1400 EDUCATION WAY, PT CHARLOTTE, FL 33948-1000
(941) 625-9800
Mailing address
PO BOX 864602, ORLANDO, FL 32886-4602
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
10/20/2009
Last updated
11/03/2009
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