Provider Demographics
NPI:1265182257
Name:NORTH SHORE CHIROPRACTIC CENTER LLC
Entity type:Organization
Organization Name:NORTH SHORE CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/DR. OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCCO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-914-6884
Mailing Address - Street 1:33 6TH STREET SOUTH
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701
Mailing Address - Country:US
Mailing Address - Phone:727-914-6884
Mailing Address - Fax:727-498-3951
Practice Address - Street 1:33 6TH STREET SOUTH
Practice Address - Street 2:SUITE 600
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701
Practice Address - Country:US
Practice Address - Phone:727-914-6884
Practice Address - Fax:727-498-3951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty