Provider Demographics
NPI:1699920967
Name:RAEMISCH CHIROPRACTIC LLC
Entity type:Organization
Organization Name:RAEMISCH CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:T
Authorized Official - Last Name:RAEMISCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:863-421-9700
Mailing Address - Street 1:82 MAXCY PLAZA CIR
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-2488
Mailing Address - Country:US
Mailing Address - Phone:863-421-9700
Mailing Address - Fax:863-421-1953
Practice Address - Street 1:82 MAXCY PLAZA CIR
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-2488
Practice Address - Country:US
Practice Address - Phone:863-421-9700
Practice Address - Fax:863-421-1953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty