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General NPI Number Information
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NPI Number | 1396002952
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Entity Type | Organization
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Legal Business Name | SYNERGY CHIROPRACTIC AND HEALTH CENTER PA
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 13020 LIVINGSTON RD SUITE 14
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City | NAPLES
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State | FL
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Zip | 34105-5021
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Country | US
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Telephone | 239-263-3330
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Fax | 239-263-7492
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Provider Business Mailing Address
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Address Line | 13020 LIVINGSTON RD SUITE 14
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City | NAPLES
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State | FL
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Zip | 34105-5021
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Country | US
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Telephone | 239-263-3330
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Fax | 239-263-7492
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Authorized Official
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Title or Position | PRES/DIRECTOR
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Name | DR. STEPHANIE ANN AHASIC
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Credential | DC
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Telephone | 239-263-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH10286
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License Number State | FL
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