Provider Demographics
NPI:1013490556
Name:DADE CITY CHIROPRACTIC
Entity Type:Organization
Organization Name:DADE CITY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-523-1070
Mailing Address - Street 1:3431 PARKWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-4720
Mailing Address - Country:US
Mailing Address - Phone:813-523-1070
Mailing Address - Fax:813-575-9771
Practice Address - Street 1:14122 7TH ST STE 2
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525-4216
Practice Address - Country:US
Practice Address - Phone:813-563-6352
Practice Address - Fax:813-575-9771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty