Provider Demographics
NPI:1649506346
Name:ACCIDENT RECOVERY CENTER OF PALMETTO
Entity type:Organization
Organization Name:ACCIDENT RECOVERY CENTER OF PALMETTO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMIKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-761-4994
Mailing Address - Street 1:449 10TH AVE W
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-5031
Mailing Address - Country:US
Mailing Address - Phone:941-729-5727
Mailing Address - Fax:941-729-5679
Practice Address - Street 1:449 10TH AVE W
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-5031
Practice Address - Country:US
Practice Address - Phone:941-729-5727
Practice Address - Fax:941-729-5679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty