Provider Demographics
NPI:1013556315
Name:TITAN CHIROPRACTIC & REHAB
Entity Type:Organization
Organization Name:TITAN CHIROPRACTIC & REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHALLONIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-399-5085
Mailing Address - Street 1:655 N MILITARY TRAIL STE 9
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415
Mailing Address - Country:US
Mailing Address - Phone:352-399-5085
Mailing Address - Fax:866-402-3481
Practice Address - Street 1:655 N MILITARY TRAIL STE 9
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415
Practice Address - Country:US
Practice Address - Phone:352-399-5085
Practice Address - Fax:866-402-3481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty