Provider Demographics
NPI:1639464472
Name:LIGERTWOOD CHIROPRACTIC CLINIC, INC.
Entity Type:Organization
Organization Name:LIGERTWOOD CHIROPRACTIC CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:LIGERTWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-819-2273
Mailing Address - Street 1:10129 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-3424
Mailing Address - Country:US
Mailing Address - Phone:727-819-2273
Mailing Address - Fax:727-863-9313
Practice Address - Street 1:10129 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-3424
Practice Address - Country:US
Practice Address - Phone:727-819-2273
Practice Address - Fax:727-863-9313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7653111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty