Provider Demographics
NPI:1962706101
Name:DEFINIS CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:DEFINIS CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:DEFINIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-574-4564
Mailing Address - Street 1:410 DEL PRADO BLVD NORTH
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-2243
Mailing Address - Country:US
Mailing Address - Phone:239-574-4564
Mailing Address - Fax:
Practice Address - Street 1:410 DEL PRADO BLVD N
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-2243
Practice Address - Country:US
Practice Address - Phone:239-574-4564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty