Provider Demographics
NPI:1467542589
Name:CHIROPRACTIC CENTRE & ASSOC
Entity Type:Organization
Organization Name:CHIROPRACTIC CENTRE & ASSOC
Other - Org Name:T STEPHEN HINES DC INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:T
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-687-2800
Mailing Address - Street 1:2119 PINE RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472
Mailing Address - Country:US
Mailing Address - Phone:352-687-2800
Mailing Address - Fax:352-687-1108
Practice Address - Street 1:2119 PINE RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472
Practice Address - Country:US
Practice Address - Phone:352-687-2800
Practice Address - Fax:352-687-1108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T55982Medicare UPIN
K3431Medicare ID - Type Unspecified