Doctor Name: | DR. JUSTIN COUGH |
NPI Number: | 1144631821 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | CH11206 |
Business Practice Address: | 2871 Clayton Crossing Way Suite 1073 Oviedo, FL - 327653426 |
Business Phone Number: | 4075421614 |
Business Fax Number: | 4075421615 |
Mailing Address: | 2871 Clayton Crossing Way, Suite 1073 OVIEDO |
State: | FL |
Postal Code: | 327653426 |
Phone Number: | 4075421614 |
Fax Number: | 4075421615 |
NPI Enumeration Date: | 05/15/2014 |
NPI Last Update Date: | 03/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | CH11206 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |