Provider Demographics
NPI:1184838013
Name:LANDERS, CATHLEEN QUACH (DC)
Entity Type:Individual
Prefix:DR
First Name:CATHLEEN
Middle Name:QUACH
Last Name:LANDERS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 VENUS AVE
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-2748
Mailing Address - Country:US
Mailing Address - Phone:386-532-3503
Mailing Address - Fax:386-775-7101
Practice Address - Street 1:177 E GRAVES AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-5263
Practice Address - Country:US
Practice Address - Phone:386-775-1168
Practice Address - Fax:386-775-7101
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7933111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL80-006010OtherTAX ID
FL80-006010OtherTAX ID