Provider Demographics
NPI:1649558743
Name:WEST FAMILY CHIROPRACTIC, P.A.
Entity Type:Organization
Organization Name:WEST FAMILY CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-332-1992
Mailing Address - Street 1:5010 W NEWBERRY RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-5212
Mailing Address - Country:US
Mailing Address - Phone:352-332-1992
Mailing Address - Fax:352-332-1993
Practice Address - Street 1:5010 W NEWBERRY RD
Practice Address - Street 2:SUITE D
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-5212
Practice Address - Country:US
Practice Address - Phone:352-332-1992
Practice Address - Fax:352-332-1993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8280111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70227OtherBCBS PROVIDER NUMBER
FL70227OtherBCBS PROVIDER NUMBER