Provider Demographics
NPI:1962677260
Name:ABSOLUTE HEALTHCARE ADVANCED CHIROPRACTIC P A
Entity Type:Organization
Organization Name:ABSOLUTE HEALTHCARE ADVANCED CHIROPRACTIC P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:PATE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:772-344-4890
Mailing Address - Street 1:1973 SW SAVAGE BLVD
Mailing Address - Street 2:111
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-2791
Mailing Address - Country:US
Mailing Address - Phone:772-344-4890
Mailing Address - Fax:772-286-1448
Practice Address - Street 1:1973 SW SAVAGE BLVD
Practice Address - Street 2:111
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-2791
Practice Address - Country:US
Practice Address - Phone:772-344-4890
Practice Address - Fax:772-286-1448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9533261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care