| St. Lucie Injury And Health, Llc | |
|
4842 N Kings Hwy Fort Pierce FL 34951-2243 | |
| (772) 882-0701 | |
| (888) 920-1114 |
| Full Name | St. Lucie Injury And Health, Llc |
|---|---|
| Speciality | Chiropractor |
| Location | 4842 N Kings Hwy, Fort Pierce, Florida |
| Authorized Official Name and Position | Susan Parker Sanders (CEO) |
| Authorized Official Contact | 7728820701 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Lucie Injury And Health, Llc 4842 N Kings Hwy Fort Pierce FL 34951-2243 Ph: (772) 882-0701 | St. Lucie Injury And Health, Llc 4842 N Kings Hwy Fort Pierce FL 34951-2243 Ph: (772) 882-0701 |
| NPI Number | 1770096653 |
|---|---|
| Provider Enumeration Date | 11/14/2017 |
| Last Update Date | 01/04/2021 |
| Medicare PECOS PAC ID | 9032473921 |
|---|---|
| Medicare Enrollment ID | O20180430002519 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770096653 | NPI | - | NPPES |
| 019857200 | Medicaid | FL | |
| 8754334744 | Other | DOT ME# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 111NR0400X | Chiropractor - Rehabilitation | (* (Not Available)) | Primary |
| Provider Name | Susan Parker Sanders |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1689727620 PECOS PAC ID: 1951540582 Enrollment ID: I20130717000467 |
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