Organization
CHIROPRACTIC SPORT AND FAMILY WELLNESS LLC
Active
Organization
CHIROPRACTIC SPORT AND FAMILY WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE D RICHARDSON-SICRE DC (REGISTERED AGENT)
(571) 220-1362
Entity
Organization
Contact information
Practice address
13224 SR 64, BRADENTON, FL 34212-9403
(941) 777-2739
Mailing address
13224 SR 64, BRADENTON, FL 34212-9403
(941) 777-2739
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
—
—
Other
Enumeration date
12/08/2023
Last updated
12/08/2023
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