Provider Demographics
NPI:1275670374
Name:KAREN CANN
Entity Type:Organization
Organization Name:KAREN CANN
Other - Org Name:INTEGRATIVE CHIROPRACTIC & PHYSICAL THERAPY SOLUTIONS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CANN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LPT
Authorized Official - Phone:850-916-9304
Mailing Address - Street 1:4657 GULF BREEZE PKWY.
Mailing Address - Street 2:SUITE A
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563
Mailing Address - Country:US
Mailing Address - Phone:850-916-9304
Mailing Address - Fax:850-916-9306
Practice Address - Street 1:4657 GULF BREEZE PKWY.
Practice Address - Street 2:SUITES A & B
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563
Practice Address - Country:US
Practice Address - Phone:850-916-9304
Practice Address - Fax:850-916-9306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8649111N00000X
FLPT20841225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3821684Medicaid
FL3821684Medicaid
V6935ZMedicare UPIN
U6935ZMedicare ID - Type Unspecified
FLK9231Medicare PIN