Organization
MUA OF CHARLOTTE COUNTY LLC
Active
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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