Provider Demographics
NPI:1609916055
Name:PLEASANT HILL FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:PLEASANT HILL FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAVION
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:407-931-1492
Mailing Address - Street 1:1672 PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746
Mailing Address - Country:US
Mailing Address - Phone:407-931-1492
Mailing Address - Fax:
Practice Address - Street 1:1672 PLEASANT HILL ROAD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746
Practice Address - Country:US
Practice Address - Phone:407-931-1492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9319111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAC953Medicare PIN