Provider Demographics
NPI:1366456345
Name:BARTZ CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:BARTZ CHIROPRACTIC, LLC
Other - Org Name:BARTZ CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-772-5582
Mailing Address - Street 1:1316 SW 4TH TER
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-1421
Mailing Address - Country:US
Mailing Address - Phone:239-772-5582
Mailing Address - Fax:239-772-5215
Practice Address - Street 1:1316 SW 4TH TER
Practice Address - Street 2:SUITE 102
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-1421
Practice Address - Country:US
Practice Address - Phone:239-772-5582
Practice Address - Fax:239-772-5215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty