Provider Demographics
NPI:1013095322
Name:HILL FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:HILL FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:386-226-0081
Mailing Address - Street 1:298 S NOVA RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-0412
Mailing Address - Country:US
Mailing Address - Phone:386-226-0081
Mailing Address - Fax:386-226-2148
Practice Address - Street 1:298 S NOVA RD
Practice Address - Street 2:SUITE E
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-0412
Practice Address - Country:US
Practice Address - Phone:386-226-0081
Practice Address - Fax:386-226-2148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0009093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL382027100Medicaid
FL1407812258OtherINDIVIDUAL NPI
FL69024OtherBCBS
FLAC926OtherMEDICARE GROUP NUMBER
FL382027100Medicaid
FLV08010Medicare UPIN