Provider Demographics
NPI:1568606499
Name:BARE CENTER FOR CHIROPRACTIC WELLNESS LLC
Entity Type:Organization
Organization Name:BARE CENTER FOR CHIROPRACTIC WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CACY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-369-6325
Mailing Address - Street 1:3773 S PINE AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-6608
Mailing Address - Country:US
Mailing Address - Phone:352-369-6325
Mailing Address - Fax:352-369-6329
Practice Address - Street 1:3773 S PINE AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-6608
Practice Address - Country:US
Practice Address - Phone:352-369-6325
Practice Address - Fax:352-369-6329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9163111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty