Provider Demographics
NPI:1588905780
Name:SUMMIT CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:SUMMIT CHIROPRACTIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMEE
Authorized Official - Middle Name:J
Authorized Official - Last Name:FIKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-203-6745
Mailing Address - Street 1:11547 LAKE UNDERHILL RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5001
Mailing Address - Country:US
Mailing Address - Phone:407-203-6745
Mailing Address - Fax:407-442-0521
Practice Address - Street 1:11547 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-5001
Practice Address - Country:US
Practice Address - Phone:407-203-6745
Practice Address - Fax:407-442-0521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2018-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty