Provider Demographics
NPI:1447446828
Name:CHIRO-MED HEALTH AND REHAB PL
Entity type:Organization
Organization Name:CHIRO-MED HEALTH AND REHAB PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-697-3001
Mailing Address - Street 1:12479 S ACCESS RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33981-6206
Mailing Address - Country:US
Mailing Address - Phone:941-697-3001
Mailing Address - Fax:941-697-3003
Practice Address - Street 1:12479 S ACCESS RD
Practice Address - Street 2:SUITE 1
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33981-6206
Practice Address - Country:US
Practice Address - Phone:941-697-3001
Practice Address - Fax:941-697-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8838111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty