Active Chiropractic, LLC
Chiropractor in Clearwater, FL. Organization (NPI-2).
NPI number1558880849
StatusActive
Last updated in NPPESJul 8, 2024
Details
- NPI
- 1558880849
- Entity type
- Organization (NPI-2)
- Legal business name
- Active Chiropractic, LLC
- Organization subpart
- No
- Enumeration date
- Sep 18, 2017
- Certification date
- Jun 26, 2024
- Last updated
- Jul 8, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | CH9770 | FL | Yes |
| 111N00000X | Chiropractor | CH10813 | FL |
Other names
- Countryside Chiropractic (Doing Business As)
Practice location
28051 Us Highway 19 N Ste 106Clearwater, FL 33761-2642
Phone 727-400-6000 · Fax 727-999-6001
Mailing address
28051 Us Highway 19 N Ste 106Clearwater, FL 33761-2642
Phone 727-400-6000 · Fax 727-999-6001
Authorized official
Maria A Young
Owner
7274006000
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