Provider Demographics
NPI:1427384494
Name:THEECK, JOHN C (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:THEECK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 LAUREL MANOR DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-5603
Mailing Address - Country:US
Mailing Address - Phone:734-775-2068
Mailing Address - Fax:
Practice Address - Street 1:1950 LAUREL MANOR DR
Practice Address - Street 2:BUILDING 200, SUITE 204
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5603
Practice Address - Country:US
Practice Address - Phone:325-295-0024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor