Provider Demographics
NPI: | 1760791016 |
---|---|
Name: | A ALTERNATIVE HEALTH CENTER, P.A. |
Entity Type: | Organization |
Organization Name: | A ALTERNATIVE HEALTH CENTER, P.A. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | SHARON |
Authorized Official - Middle Name: | KAY |
Authorized Official - Last Name: | MCCRAY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DC |
Authorized Official - Phone: | 727-359-7603 |
Mailing Address - Street 1: | 4916 POMPANO DR |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW PORT RICHEY |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 34652-4497 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 727-724-4288 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 35170 US HIGHWAY 19 N |
Practice Address - Street 2: | |
Practice Address - City: | PALM HARBOR |
Practice Address - State: | FL |
Practice Address - Zip Code: | 34684-1929 |
Practice Address - Country: | US |
Practice Address - Phone: | 727-359-7603 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-10-05 |
Last Update Date: | 2010-10-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | CH7848 | 111N00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor | Group - Single Specialty |