Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CH8280 | FL |
NPI | 1285648337 |
---|---|
Provider Name | Dr. David Ryan West |
First Address | Gainesville, FL 32607-5213 |
Second Address | Gainesville, FL 32607-1695 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 21/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
70227 | BCBS (01) | FL |
76229 | (02) | FL |