Provider Demographics
NPI:1366792830
Name:EMMONS, ERIC WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:WILLIAM
Last Name:EMMONS
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 1:1419 HEMPEL AVE
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-8115
Mailing Address - Country:US
Mailing Address - Phone:321-544-7031
Mailing Address - Fax:
Practice Address - Street 1:316 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4246
Practice Address - Country:US
Practice Address - Phone:407-886-2299
Practice Address - Fax:407-886-1227
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor