Provider Demographics
NPI:1699829713
Name:BITTIKER CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:BITTIKER CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:BITTIKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-868-8729
Mailing Address - Street 1:7135 STATE ROAD 52
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-6782
Mailing Address - Country:US
Mailing Address - Phone:727-868-8770
Mailing Address - Fax:727-869-0302
Practice Address - Street 1:7135 STATE ROAD 52
Practice Address - Street 2:SUITE 304
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-6782
Practice Address - Country:US
Practice Address - Phone:727-868-8770
Practice Address - Fax:727-869-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0002359111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88424Medicare ID - Type Unspecified
FLT88424Medicare UPIN