Provider Demographics
NPI:1568278968
Name:INNOVO CHIROPRACTIC LLC
Entity type:Organization
Organization Name:INNOVO CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWEITZER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-277-2843
Mailing Address - Street 1:145 LAND GRANT STREET, SUITE 4
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092
Mailing Address - Country:US
Mailing Address - Phone:904-250-0205
Mailing Address - Fax:756-104-0591
Practice Address - Street 1:145 LAND GRANT STREET, SUITE 4
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092
Practice Address - Country:US
Practice Address - Phone:904-250-0205
Practice Address - Fax:756-104-0591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty