Provider Demographics
NPI:1346424793
Name:CALHOUN CHIROPRACTIC CENTER, P.A
Entity Type:Organization
Organization Name:CALHOUN CHIROPRACTIC CENTER, P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-230-1288
Mailing Address - Street 1:16600 PANAMA CITY BEACH PKWY
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32413-2219
Mailing Address - Country:US
Mailing Address - Phone:850-230-1288
Mailing Address - Fax:850-230-6122
Practice Address - Street 1:16600 PANAMA CITY BEACH PKWY
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32413-2219
Practice Address - Country:US
Practice Address - Phone:850-230-1288
Practice Address - Fax:850-230-6122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 6508111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22787ZMedicare PIN