Venice Village Chiropractic Clinic PA

NPI #1033302492 in Venice, Florida

Provider Information

NPI Number: 1033302492
Entity Type: Organization
Organization Name: Venice Village Chiropractic Clinic PA
Primary Specialty: Chiropractor
Enumeration Date: Aug 20, 2007
Last Updated: Aug 20, 2007

Practice Location

Address: 4140 WOODMERE PARK BLVD
Address 2: STE 2
City: Venice
State: Florida
ZIP Code: 34293-2205
Phone: (941) 497-7424

Authorized Official

Name: DR. GARY E BOLEN, DC
Title: PRESIDENT OWNER
Phone: (941) 497-7424

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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