Provider Demographics
NPI:1588677140
Name:CHIROPRACTIC RADIOLOGY CONSULTANTS, P.A.
Entity Type:Organization
Organization Name:CHIROPRACTIC RADIOLOGY CONSULTANTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:ATHERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-895-6408
Mailing Address - Street 1:795 NE 127TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4826
Mailing Address - Country:US
Mailing Address - Phone:305-895-6408
Mailing Address - Fax:
Practice Address - Street 1:795 NE 127TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-4826
Practice Address - Country:US
Practice Address - Phone:305-895-6408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7981111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74523OtherBC/BS PROVIDER NUMBER