Provider Demographics
NPI:1780341370
Name:HELP FROM ABOVE CHIROPRACTIC
Entity type:Organization
Organization Name:HELP FROM ABOVE CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:772-240-8009
Mailing Address - Street 1:2050 OLEANDER BLVD APT 8-201
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-5335
Mailing Address - Country:US
Mailing Address - Phone:772-240-8009
Mailing Address - Fax:772-413-7025
Practice Address - Street 1:2050 OLEANDER BLVD APT 8-201
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-5335
Practice Address - Country:US
Practice Address - Phone:772-240-8009
Practice Address - Fax:772-413-7025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-18
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH12001OtherLICENSE
FL1104963200Medicaid