Provider Demographics
NPI:1750651741
Name:ALACHUA CHIROPRACTIC INCORPORATED
Entity Type:Organization
Organization Name:ALACHUA CHIROPRACTIC INCORPORATED
Other - Org Name:BACK TO HEALTH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DISIMILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-512-0530
Mailing Address - Street 1:1521 SE 36TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4936
Mailing Address - Country:US
Mailing Address - Phone:352-512-0530
Mailing Address - Fax:352-512-0531
Practice Address - Street 1:1521 SE 36TH AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4936
Practice Address - Country:US
Practice Address - Phone:352-512-0530
Practice Address - Fax:352-512-0531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9584111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty