Provider Demographics
NPI:1467679456
Name:PREMIER NAPLES CHIROPRACTIC, PA
Entity type:Organization
Organization Name:PREMIER NAPLES CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GROSSI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-504-7490
Mailing Address - Street 1:12268 TAMIAMI TRL E STE 302
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34113-7946
Mailing Address - Country:US
Mailing Address - Phone:239-799-7168
Mailing Address - Fax:
Practice Address - Street 1:12268 TAMIAMI TRL E STE 302
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-7946
Practice Address - Country:US
Practice Address - Phone:239-799-7168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2633111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45474Medicare ID - Type Unspecified