Provider Demographics
NPI:1427341973
Name:CANUEL CHIROPRACTIC & MASSAGE, INC
Entity type:Organization
Organization Name:CANUEL CHIROPRACTIC & MASSAGE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR CLINIC OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CANUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-499-4608
Mailing Address - Street 1:1070 S WICKHAM RD
Mailing Address - Street 2:
Mailing Address - City:W MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-1653
Mailing Address - Country:US
Mailing Address - Phone:321-499-4608
Mailing Address - Fax:321-499-4607
Practice Address - Street 1:1070 S WICKHAM RD
Practice Address - Street 2:
Practice Address - City:W MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-1653
Practice Address - Country:US
Practice Address - Phone:321-499-4608
Practice Address - Fax:321-499-4607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8309111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty