Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 10900 | FL |
NPI | 1003258336 |
---|---|
Provider Name | Dr. Eric Pragle |
First Address | Tallahassee, FL 32301-5905 |
Second Address | Tallahassee, FL 32301-5905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2013 |
Last Update Date | 29/07/2013 |