Provider Demographics
NPI:1063037448
Name:PANAMA CITY CHIROPRACTIC AND AUTO INJURY LLC
Entity Type:Organization
Organization Name:PANAMA CITY CHIROPRACTIC AND AUTO INJURY LLC
Other - Org Name:SEASIDE SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLYN
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:NEWBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-460-2362
Mailing Address - Street 1:221 E 23RD ST STE A
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4557
Mailing Address - Country:US
Mailing Address - Phone:850-215-1747
Mailing Address - Fax:850-215-1748
Practice Address - Street 1:221 E 23RD ST STE A
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4557
Practice Address - Country:US
Practice Address - Phone:850-215-1747
Practice Address - Fax:850-215-1748
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEASIDE SPINE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-11
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty