Provider Demographics
NPI:1568199859
Name:KEY CHIROPRACTIC CLINIC, LLC
Entity Type:Organization
Organization Name:KEY CHIROPRACTIC CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:BIRCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-899-5937
Mailing Address - Street 1:PO BOX 8725
Mailing Address - Street 2:
Mailing Address - City:LONGBOAT KEY
Mailing Address - State:FL
Mailing Address - Zip Code:34228-8725
Mailing Address - Country:US
Mailing Address - Phone:941-899-5937
Mailing Address - Fax:941-383-7742
Practice Address - Street 1:6350 GULF OF MEXICO DR STE 103B
Practice Address - Street 2:
Practice Address - City:LONGBOAT KEY
Practice Address - State:FL
Practice Address - Zip Code:34228-1501
Practice Address - Country:US
Practice Address - Phone:941-899-5937
Practice Address - Fax:941-383-7742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty