Provider Demographics
NPI:1831876309
Name:DNA CHIROPRACTIC AND PERFORMANCE LLC
Entity type:Organization
Organization Name:DNA CHIROPRACTIC AND PERFORMANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDREA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-359-3192
Mailing Address - Street 1:17246 NW 173RD DR
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-0060
Mailing Address - Country:US
Mailing Address - Phone:352-792-5002
Mailing Address - Fax:
Practice Address - Street 1:15202 NW 147TH DR STE 1500
Practice Address - Street 2:
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615-5337
Practice Address - Country:US
Practice Address - Phone:352-359-3192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty