MEDICARE: UNGER CHIROPRACTIC CLINIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH9507	FL

General Provider Information

NPI Number	:	1184951675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNGER CHIROPRACTIC CLINIC LLC

Provider Business Mailing Address
First Line	:	2154 DUCK SLOUGH BLVD
Second Line	:	SUITE 103
City	:	TRINITY
State	:	FL
Zip	:	34655-5003
Country	:	US
Telephone Number	:	727-264-8888
Fax Number	:	727-264-8817

Provider Business Practice Location Address
First Line	:	2154 DUCK SLOUGH BLVD
Second Line	:	SUITE 103
City	:	TRINITY
State	:	FL
Zip	:	34655-5003
Country	:	US
Telephone Number	:	727-264-8888
Fax Number	:	727-264-8817

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEPHEN JOHN UNGER
Credential	:	D.C.
Telephone Number	:	727-264-8888

Provider Enumeration Date	:	11/04/2009
Last Update Date	:	11/04/2009

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