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NPI Code Detail

MEDICARE: ADVANCE CHIROPRACTIC ADJUSTMENT

MEDICARE: ADVANCE CHIROPRACTIC ADJUSTMENT
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
1111N00000XChiropractorHCC7872FL

General Provider Information

NPI Number : 1619157476
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCE CHIROPRACTIC ADJUSTMENT
Provider Business Mailing Address
First Line : 280 PATTERSON RD
Second Line : SUITE #2
City : HAINES CITY
State : FL
Zip : 33844-6261
Country : US
Telephone Number : 863-421-8687
Fax Number : 863-421-8670
Provider Business Practice Location Address
First Line : 280 PATTERSON RD
Second Line : SUITE #2
City : HAINES CITY
State : FL
Zip : 33844-6261
Country : US
Telephone Number : 863-421-8687
Fax Number : 863-421-8670
Authorized Official
Title or Position : OWNER
Name : MS. ROSE MARLENE LUBIN
Credential :
Telephone Number : 863-421-8687
Provider Enumeration Date : 11/09/2007
Last Update Date : 11/09/2007

Similar Medicare Providers

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Directions to “ADVANCE CHIROPRACTIC ADJUSTMENT ” Practice Location

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