Provider Demographics
NPI:1811373277
Name:SEASIDE CHIROPRACTIC INC
Entity Type:Organization
Organization Name:SEASIDE CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:MERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-451-3337
Mailing Address - Street 1:99198 OVERSEAS HWY STE 8
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-2437
Mailing Address - Country:US
Mailing Address - Phone:305-451-3337
Mailing Address - Fax:305-453-3338
Practice Address - Street 1:99198 OVERSEAS HWY STE 8
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-2437
Practice Address - Country:US
Practice Address - Phone:305-451-3337
Practice Address - Fax:305-453-3338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty