Provider Demographics
NPI:1265696215
Name:STEVEN G CHANCE DC PA
Entity type:Organization
Organization Name:STEVEN G CHANCE DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:CHANCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-466-5656
Mailing Address - Street 1:16731 MCGREGOR BLVD
Mailing Address - Street 2:SUITE 111 AND 112
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-3843
Mailing Address - Country:US
Mailing Address - Phone:239-466-5656
Mailing Address - Fax:239-466-1102
Practice Address - Street 1:16731 MCGREGOR BLVD
Practice Address - Street 2:SUITE 111 AND 112
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3843
Practice Address - Country:US
Practice Address - Phone:239-466-5656
Practice Address - Fax:239-466-1102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 1919111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty