Provider Demographics
NPI:1659599769
Name:CHIROPRACTIC CARE OF GOLF COAST INC
Entity Type:Organization
Organization Name:CHIROPRACTIC CARE OF GOLF COAST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-248-7210
Mailing Address - Street 1:201 8TH ST S
Mailing Address - Street 2:SUITE 307
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6107
Mailing Address - Country:US
Mailing Address - Phone:239-248-7210
Mailing Address - Fax:239-530-7002
Practice Address - Street 1:201 8TH ST S
Practice Address - Street 2:SUITE 307
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6107
Practice Address - Country:US
Practice Address - Phone:239-248-7210
Practice Address - Fax:239-530-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7088111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU98613Medicare ID - Type Unspecified