Provider Demographics
NPI:1154643922
Name:MADISON CHIROPRACTIC CENTER, LLC
Entity Type:Organization
Organization Name:MADISON CHIROPRACTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:N
Authorized Official - Last Name:STEIGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-973-2424
Mailing Address - Street 1:126 SW SUMATRA AVE UNIT A
Mailing Address - Street 2:PO BOX 306
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32340-1458
Mailing Address - Country:US
Mailing Address - Phone:850-973-2424
Mailing Address - Fax:850-973-2684
Practice Address - Street 1:126 SW SUMATRA AVE UNIT A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-1458
Practice Address - Country:US
Practice Address - Phone:850-973-2424
Practice Address - Fax:850-973-2684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4070111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001907100Medicaid
FL001907100Medicaid
FLT95342Medicare UPIN