Provider Demographics
NPI:1063027316
Name:PROCARE CHIROPRACTIC AND REHAB
Entity Type:Organization
Organization Name:PROCARE CHIROPRACTIC AND REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-221-1072
Mailing Address - Street 1:3240 W LAKE MARY BLVD STE 1300
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3583
Mailing Address - Country:US
Mailing Address - Phone:407-302-5161
Mailing Address - Fax:407-302-5175
Practice Address - Street 1:40 ALEXANDRIA BLVD STE 1020
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8910
Practice Address - Country:US
Practice Address - Phone:407-359-0047
Practice Address - Fax:407-359-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty