Provider Demographics
NPI:1770739484
Name:UNIQUE CHIROPRACTIC INC
Entity type:Organization
Organization Name:UNIQUE CHIROPRACTIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:MEDHI
Authorized Official - Last Name:HAMTAEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:863-688-2200
Mailing Address - Street 1:1048 S FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-1118
Mailing Address - Country:US
Mailing Address - Phone:863-688-2200
Mailing Address - Fax:863-688-2210
Practice Address - Street 1:1048 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-1118
Practice Address - Country:US
Practice Address - Phone:863-688-2200
Practice Address - Fax:863-688-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAW956AMedicare PIN