Provider Demographics
NPI:1639385453
Name:FIRST CHOICE CARE CHIROPRACTIC AND REHABILITATION CENTER, INC
Entity Type:Organization
Organization Name:FIRST CHOICE CARE CHIROPRACTIC AND REHABILITATION CENTER, INC
Other - Org Name:SAME NAME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:HARRY
Authorized Official - Last Name:MAURICE
Authorized Official - Suffix:
Authorized Official - Credentials:HEALTH CARE CLINIC
Authorized Official - Phone:863-299-3050
Mailing Address - Street 1:1082 HAVENDALE BLVD NW
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-1354
Mailing Address - Country:US
Mailing Address - Phone:863-299-3050
Mailing Address - Fax:863-299-4016
Practice Address - Street 1:1082 HAVENDALE BLVD NW
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-1354
Practice Address - Country:US
Practice Address - Phone:863-299-3050
Practice Address - Fax:863-299-4016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC 7310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty