| Bluewater Chiropractic Wellness Center Llc | |
|
60 2nd St Unit C-7 Shalimar FL 32579-1769 | |
| (850) 613-4125 | |
| (850) 613-4148 |
| Full Name | Bluewater Chiropractic Wellness Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 60 2nd St Unit C-7, Shalimar, Florida |
| Authorized Official Name and Position | April W Lee (OWNER) |
| Authorized Official Contact | 8506134125 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluewater Chiropractic Wellness Center Llc 60 2nd St Unit C-7 Shalimar FL 32579-1769 Ph: (850) 613-4125 | Bluewater Chiropractic Wellness Center Llc 60 2nd St Unit C-7 Shalimar FL 32579-1769 Ph: (850) 613-4125 |
| NPI Number | 1992942692 |
|---|---|
| Provider Enumeration Date | 01/16/2009 |
| Last Update Date | 06/13/2023 |
| Medicare PECOS PAC ID | 8224193156 |
|---|---|
| Medicare Enrollment ID | O20090210000353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992942692 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | CH9247 (Florida) | Primary |
| Provider Name | April W Lee |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1720072341 PECOS PAC ID: 2365495728 Enrollment ID: I20090205000242 |
| Provider Name | Bambi R Denais |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1457683245 PECOS PAC ID: 5193857563 Enrollment ID: I20180220000012 |
| Provider Name | Letitia C Smith |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1477021327 PECOS PAC ID: 2466797931 Enrollment ID: I20190103000556 |
Brd Wellness Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 60 2nd St Unit C-7, Shalimar, FL 32579 Phone: 850-613-4125 |