Provider Demographics
NPI:1386894582
Name:COMPTON CHIROPRACTIC CLINIC INC
Entity type:Organization
Organization Name:COMPTON CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-949-2225
Mailing Address - Street 1:21835 RAINBOW LAKE CT
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-6297
Mailing Address - Country:US
Mailing Address - Phone:239-949-2225
Mailing Address - Fax:
Practice Address - Street 1:21835 RAINBOW LAKE CT
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-6297
Practice Address - Country:US
Practice Address - Phone:239-949-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8197111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty