Provider Demographics
NPI:1649677816
Name:BAYWEST CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:BAYWEST CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING OFFICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-585-6027
Mailing Address - Street 1:1446 COURT ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-6147
Mailing Address - Country:US
Mailing Address - Phone:727-441-2915
Mailing Address - Fax:727-441-2950
Practice Address - Street 1:1446 COURT ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-6147
Practice Address - Country:US
Practice Address - Phone:727-441-2915
Practice Address - Fax:727-441-2950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E58524OtherMEDICARE ID-TYPE UNSPECIFIED
U86006Medicare UPIN