Provider Demographics
NPI:1821256850
Name:SPRING HILL CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:SPRING HILL CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:JESSICA
Authorized Official - Last Name:CRIVELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-684-1484
Mailing Address - Street 1:14270 SPRING HILL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-5259
Mailing Address - Country:US
Mailing Address - Phone:352-684-1484
Mailing Address - Fax:352-684-1420
Practice Address - Street 1:14270 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5259
Practice Address - Country:US
Practice Address - Phone:352-684-1484
Practice Address - Fax:352-684-1420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8199111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL382141200Medicaid
FLK6993Medicare PIN
FL382141200Medicaid