Space Coast Total Health Care

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH4422 Issued in FL

Legal business name

SPACE COAST TOTAL HEALTH CARE

Practice address

5240 Babcock St NE
Suite 305
Palm Bay, FL 32905-4692

Phone

(321) 725-8778

Fax

(321) 984-5299

NPI assigned

Sep 6, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bradley Je Clow, DC

Title

President

Phone

(321) 725-8778

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750375820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 BABCOCK ST NE",
            "address_2": "SUITE 305",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329054692",
            "telephone_number": "321-725-8778",
            "fax_number": "321-984-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5240 BABCOCK ST NE",
            "address_2": "SUITE 305",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329054692",
            "telephone_number": "321-725-8778",
            "fax_number": "321-984-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST TOTAL HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLOW",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "JE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-725-8778",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH4422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Space Coast Eye Care Inc.
• Space Coast Hospitalists LLC
• Space Coast Medical Management LLC
• Space Coast Neurology and Pain Management PA
• Space Coast Podiatry LLC
• Spacecoast Wound Specialist LLC
• Beverley W. Spalding, ARNP
• James Spanogle
• Specialized Treatment, Education and Prevention Services Inc.
• Speech, Language, and Consultative Serives, LLC

• Chiropractor in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.