Healthcare Provider Details

I. General information

NPI: 1265758924
Provider Name (Legal Business Name): IHC MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9446 W COLONIAL DR
OCOEE FL
34761-6800
US

IV. Provider business mailing address

9446 W COLONIAL DR
OCOEE FL
34761-6800
US

V. Phone/Fax

Practice location:
  • Phone: 407-377-0211
  • Fax: 407-377-0214
Mailing address:
  • Phone: 407-377-0211
  • Fax: 407-377-0214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH8764
License Number StateFL

VIII. Authorized Official

Name: DR. JOSEPH ANTHONY TERRANOVA
Title or Position: CHIROPRACTIC PHYSICIAN
Credential: DC
Phone: 407-377-0211