Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH 11444 | FL |
NPI | 1003208646 |
---|---|
Provider Name | Dr. Ryne Neville |
First Address | Summerfield, FL 34491-4426 |
Second Address | Summerfield, FL 34491-4426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2015 |
Last Update Date | 18/02/2015 |