Provider Demographics
NPI:1467276477
Name:NEARSHORE CHIROPRACTIC & WELLNESS
Entity type:Organization
Organization Name:NEARSHORE CHIROPRACTIC & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGERE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-432-1772
Mailing Address - Street 1:616 10TH ST E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-2110
Mailing Address - Country:US
Mailing Address - Phone:941-225-8033
Mailing Address - Fax:
Practice Address - Street 1:616 10TH ST E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-2110
Practice Address - Country:US
Practice Address - Phone:941-225-8033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty