Provider Demographics
NPI:1871349514
Name:ELDRIDGE, GARETT (DC)
Entity type:Individual
Prefix:DR
First Name:GARETT
Middle Name:
Last Name:ELDRIDGE
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 1:1970 STATE ROAD 44
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-8349
Mailing Address - Country:US
Mailing Address - Phone:386-410-4557
Mailing Address - Fax:386-410-5106
Practice Address - Street 1:1970 STATE ROAD 44
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-8349
Practice Address - Country:US
Practice Address - Phone:386-410-4557
Practice Address - Fax:386-410-5106
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH15011111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor