Provider Demographics
NPI:1457907495
Name:BILLINGSLEY, JAMES (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BILLINGSLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 HALF MOON CIR APT B2
Mailing Address - Street 2:
Mailing Address - City:HYPOLUXO
Mailing Address - State:FL
Mailing Address - Zip Code:33462-5441
Mailing Address - Country:US
Mailing Address - Phone:314-458-7091
Mailing Address - Fax:
Practice Address - Street 1:3333 S CONGRESS AVE STE 305
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-7346
Practice Address - Country:US
Practice Address - Phone:314-458-7091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12725111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor