Provider Demographics
NPI:1346402260
Name:ABEGWEIT CHIROPRACTIC CENTER LLC
Entity Type:Organization
Organization Name:ABEGWEIT CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, DC
Authorized Official - Phone:407-421-4554
Mailing Address - Street 1:1094 OUTLOOK DR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-8329
Mailing Address - Country:US
Mailing Address - Phone:407-421-4554
Mailing Address - Fax:
Practice Address - Street 1:245 BELLAGIO CIR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-5001
Practice Address - Country:US
Practice Address - Phone:407-242-3301
Practice Address - Fax:407-358-5425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9554111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty