Provider Demographics
NPI:1336308246
Name:CEA III LLC
Entity Type:Organization
Organization Name:CEA III LLC
Other - Org Name:TOTAL HEALTH OF ORMOND BEACH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:E
Authorized Official - Last Name:ASHBY
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:386-672-3305
Mailing Address - Street 1:400 CLYDE MORRIS BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8172
Mailing Address - Country:US
Mailing Address - Phone:386-672-3305
Mailing Address - Fax:800-429-7089
Practice Address - Street 1:400 CLYDE MORRIS BLVD STE C
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8172
Practice Address - Country:US
Practice Address - Phone:386-672-3305
Practice Address - Fax:800-429-7089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7679111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty