Provider Demographics
NPI:1922185339
Name:WILLIAM EICHELROTH DC PA
Entity Type:Organization
Organization Name:WILLIAM EICHELROTH DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:EICHELROTH
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:561-262-9072
Mailing Address - Street 1:14100 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:JUNO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-1404
Mailing Address - Country:US
Mailing Address - Phone:561-262-9072
Mailing Address - Fax:561-626-6733
Practice Address - Street 1:14100 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-1404
Practice Address - Country:US
Practice Address - Phone:561-262-9072
Practice Address - Fax:561-626-6733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0002699111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88263OtherBLUE CROSS BLUE SHIELD
FL88263Medicare ID - Type Unspecified
FLT84675Medicare UPIN