Provider Demographics
NPI:1396357828
Name:MIDTOWN CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:MIDTOWN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEBASTIAN
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-533-3884
Mailing Address - Street 1:3208 LANTANA RD
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-2432
Mailing Address - Country:US
Mailing Address - Phone:561-533-3884
Mailing Address - Fax:561-439-7348
Practice Address - Street 1:3208 LANTANA RD
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-2432
Practice Address - Country:US
Practice Address - Phone:561-533-3884
Practice Address - Fax:561-439-7348
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDTOWN CLINIC OF CHIROPRACTIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty