Provider Demographics
NPI:1508141102
Name:IMMOKALEE WELLNESS CHIROPRACTIC CENTER INC.
Entity Type:Organization
Organization Name:IMMOKALEE WELLNESS CHIROPRACTIC CENTER INC.
Other - Org Name:NO
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRIETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:CECCARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-692-8591
Mailing Address - Street 1:13260 IMMOKALEE RD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-1788
Mailing Address - Country:US
Mailing Address - Phone:239-692-8591
Mailing Address - Fax:239-692-8594
Practice Address - Street 1:13260 IMMOKALEE RD
Practice Address - Street 2:SUITE #2
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-1788
Practice Address - Country:US
Practice Address - Phone:239-692-8591
Practice Address - Fax:239-692-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy