Provider Demographics
NPI:1861816548
Name:DR ERIC L HARTER LLC
Entity Type:Organization
Organization Name:DR ERIC L HARTER LLC
Other - Org Name:ABUNDANT LIFE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-772-2266
Mailing Address - Street 1:1611 SANTA BARBARA BLVD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-3439
Mailing Address - Country:US
Mailing Address - Phone:239-772-2266
Mailing Address - Fax:239-772-1017
Practice Address - Street 1:1611 SANTA BARBARA BLVD
Practice Address - Street 2:SUITE 170
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-3439
Practice Address - Country:US
Practice Address - Phone:239-772-2266
Practice Address - Fax:239-772-1017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10556111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GH557ZMedicare PIN