Provider Demographics
NPI:1275406753
Name:PEACE RIVER CHIROPRACTIC SERVICES LLC
Entity type:Organization
Organization Name:PEACE RIVER CHIROPRACTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:COREY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-208-3898
Mailing Address - Street 1:5400 RIVERSIDE DR LOT 3370
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33982-1547
Mailing Address - Country:US
Mailing Address - Phone:941-208-3898
Mailing Address - Fax:
Practice Address - Street 1:5400 RIVERSIDE DR LOT 3370
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33982-1547
Practice Address - Country:US
Practice Address - Phone:941-208-3898
Practice Address - Fax:941-429-3126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty