Provider Demographics
NPI:1629279435
Name:KASMER CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:KASMER CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:K
Authorized Official - Last Name:KASMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-629-9922
Mailing Address - Street 1:1705 E FORT KING ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-2532
Mailing Address - Country:US
Mailing Address - Phone:352-629-9922
Mailing Address - Fax:352-629-9923
Practice Address - Street 1:1705 E FORT KING ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2532
Practice Address - Country:US
Practice Address - Phone:352-629-9922
Practice Address - Fax:352-629-9923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0008223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDE5812OtherRAILROAD MEDICARE
FLU87177Medicare UPIN
FLK7802Medicare ID - Type Unspecified