Provider Demographics
NPI:1821041146
Name:LABONTE FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:LABONTE FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:LABONTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:386-677-2522
Mailing Address - Street 1:4 PEARL DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-4268
Mailing Address - Country:US
Mailing Address - Phone:386-677-2522
Mailing Address - Fax:386-677-9005
Practice Address - Street 1:4 PEARL DR
Practice Address - Street 2:SUITE 1
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-4268
Practice Address - Country:US
Practice Address - Phone:386-677-2522
Practice Address - Fax:386-677-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7891111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2034Medicare ID - Type Unspecified