Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH11147 | FL |
N | 111NN1001X | Nutrition | CH11147 | FL |
N | 111NR0400X | Rehabilitation Chiropractor | CH11147 | FL |
N | 111NS0005X | Chiropractic Sports Physician | CH11147 | FL |
NPI | 1033535596 |
---|---|
Provider Name | Dr. Michael Lee Mcpherson |
First Address | Riverview, FL 33569-5533 |
Second Address | Riverview, FL 33569-5533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2014 |
Last Update Date | 29/08/2016 |