Provider Demographics
NPI:1548441595
Name:SYNERGY CHIROPRACTIC AND WELLNESS SOLUTIONS LLC
Entity type:Organization
Organization Name:SYNERGY CHIROPRACTIC AND WELLNESS SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:B
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:386-423-2415
Mailing Address - Street 1:130 WALLACE RD
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-8069
Mailing Address - Country:US
Mailing Address - Phone:386-423-2415
Mailing Address - Fax:386-423-2417
Practice Address - Street 1:130 WALLACE RD
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-8069
Practice Address - Country:US
Practice Address - Phone:386-423-2415
Practice Address - Fax:386-423-2417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty