Provider Demographics
NPI:1407878994
Name:PRO-ADJUSTER CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:PRO-ADJUSTER CHIROPRACTIC CLINIC INC
Other - Org Name:NAPLES SPINE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:INGLESE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-435-7246
Mailing Address - Street 1:684 GOODLETTE RD N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5613
Mailing Address - Country:US
Mailing Address - Phone:239-435-7246
Mailing Address - Fax:239-435-7247
Practice Address - Street 1:684 GOODLETTE RD N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5613
Practice Address - Country:US
Practice Address - Phone:239-435-7246
Practice Address - Fax:239-435-7247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9141111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU94568Medicare UPIN
FLK9771Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
FLU7346ZMedicare ID - Type UnspecifiedMEDICARE INDIVIDUAL #