Provider Demographics
NPI:1598116741
Name:CHASE, AUSTIN
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:
Last Name:CHASE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10081 E ADAMO DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-2619
Mailing Address - Country:US
Mailing Address - Phone:813-438-6348
Mailing Address - Fax:813-438-6349
Practice Address - Street 1:10081 E ADAMO DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619
Practice Address - Country:US
Practice Address - Phone:813-438-6348
Practice Address - Fax:813-438-6349
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11850111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor