Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CH0005832 | FL |
NPI | 1235185372 |
---|---|
Provider Name | Dr. Richard Lynn Wurzler |
First Address | Titusville, FL 32796-2146 |
Second Address | Titusville, FL 32796-2146 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 26/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
380152700 | (05) | FL |
T94033 | (02) | FL |