Provider Demographics
NPI:1588092852
Name:JOINT VENTURE CHIROPRACTIC & WELLNESS LLC
Entity type:Organization
Organization Name:JOINT VENTURE CHIROPRACTIC & WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KAITLIN
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-450-0739
Mailing Address - Street 1:410 W NINE MILE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32534-1820
Mailing Address - Country:US
Mailing Address - Phone:850-471-0000
Mailing Address - Fax:850-471-0012
Practice Address - Street 1:410 W NINE MILE RD
Practice Address - Street 2:SUITE C
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32534-1820
Practice Address - Country:US
Practice Address - Phone:850-471-0000
Practice Address - Fax:850-471-0012
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. VICKI LEE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty