Provider Demographics
NPI:1659023281
Name:ORTHO ATHLETE LLC
Entity Type:Organization
Organization Name:ORTHO ATHLETE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:HEMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-363-8745
Mailing Address - Street 1:4474 CALDERA CIR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-9057
Mailing Address - Country:US
Mailing Address - Phone:802-363-8745
Mailing Address - Fax:
Practice Address - Street 1:1201 PIPER BLVD STE 21
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1385
Practice Address - Country:US
Practice Address - Phone:239-963-2226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty