Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CH6104 | FL |
NPI | 1275571598 |
---|---|
Provider Name | Dr. William Vito Adragna |
First Address | Delray Beach, FL 33446-3802 |
Second Address | Delray Beach, FL 33446-3802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
19676 | (02) | FL |