Provider Demographics
NPI:1548410301
Name:CHIROPRACTIC CENTER OF LAKELAND SOUTH, INC
Entity Type:Organization
Organization Name:CHIROPRACTIC CENTER OF LAKELAND SOUTH, INC
Other - Org Name:LOVE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:T
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:863-709-1600
Mailing Address - Street 1:PO BOX 1417
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33846-1417
Mailing Address - Country:US
Mailing Address - Phone:863-709-1600
Mailing Address - Fax:863-709-1616
Practice Address - Street 1:5227 US HIGHWAY 98 S
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33812-4291
Practice Address - Country:US
Practice Address - Phone:863-709-1600
Practice Address - Fax:863-709-1616
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHIROPRACTIC CENTER OF LAKELAND SOUTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-29
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty