Provider Demographics
NPI:1467845644
Name:FIRST OPTION CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:FIRST OPTION CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELWIRA
Authorized Official - Middle Name:EWA
Authorized Official - Last Name:KULAWIK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-486-8126
Mailing Address - Street 1:1790 E VENICE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-3191
Mailing Address - Country:US
Mailing Address - Phone:941-486-8126
Mailing Address - Fax:941-412-3599
Practice Address - Street 1:1790 E VENICE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-3191
Practice Address - Country:US
Practice Address - Phone:941-486-8126
Practice Address - Fax:941-412-3599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10483111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEBB2346OtherPTAN