Provider Demographics
NPI:1184951675
Name:UNGER CHIROPRACTIC CLINIC LLC
Entity type:Organization
Organization Name:UNGER CHIROPRACTIC CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:UNGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-264-8888
Mailing Address - Street 1:2154 DUCK SLOUGH BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5003
Mailing Address - Country:US
Mailing Address - Phone:727-264-8888
Mailing Address - Fax:727-264-8817
Practice Address - Street 1:2154 DUCK SLOUGH BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-5003
Practice Address - Country:US
Practice Address - Phone:727-264-8888
Practice Address - Fax:727-264-8817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty