Provider Demographics
NPI:1699838151
Name:COLONIAL CHIROPRACTIC ASSOCIATES
Entity Type:Organization
Organization Name:COLONIAL CHIROPRACTIC ASSOCIATES
Other - Org Name:INJURY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:TERRANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-658-8595
Mailing Address - Street 1:1850 N ALAFAYA TRL
Mailing Address - Street 2:BLDG. 1-B
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4745
Mailing Address - Country:US
Mailing Address - Phone:407-658-8595
Mailing Address - Fax:407-658-8573
Practice Address - Street 1:1850 N ALAFAYA TRL
Practice Address - Street 2:BLDG. 1-B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4745
Practice Address - Country:US
Practice Address - Phone:407-658-8595
Practice Address - Fax:407-658-8573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30120603746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty