Provider Demographics
NPI:1679822001
Name:ADVANCED CHIROPRACTIC AND REHABILITATION, INC
Entity Type:Organization
Organization Name:ADVANCED CHIROPRACTIC AND REHABILITATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN & OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-968-9800
Mailing Address - Street 1:701 W FLETCHER AVE
Mailing Address - Street 2:STE B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-3430
Mailing Address - Country:US
Mailing Address - Phone:813-968-9800
Mailing Address - Fax:813-968-9887
Practice Address - Street 1:701 W FLETCHER AVE
Practice Address - Street 2:STE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3430
Practice Address - Country:US
Practice Address - Phone:813-968-9800
Practice Address - Fax:813-968-9887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8771111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty