Healthcare Provider Details

I. General information

NPI: 1184951675
Provider Name (Legal Business Name): UNGER CHIROPRACTIC CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2009
Last Update Date: 11/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2154 DUCK SLOUGH BLVD SUITE 103
TRINITY FL
34655-5003
US

IV. Provider business mailing address

2154 DUCK SLOUGH BLVD SUITE 103
TRINITY FL
34655-5003
US

V. Phone/Fax

Practice location:
  • Phone: 727-264-8888
  • Fax: 727-264-8817
Mailing address:
  • Phone: 727-264-8888
  • Fax: 727-264-8817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH9507
License Number StateFL

VIII. Authorized Official

Name: DR. STEPHEN JOHN UNGER
Title or Position: OWNER
Credential: D.C.
Phone: 727-264-8888