Provider Demographics
NPI:1720512734
Name:ACHIEVE HEALTH & CHIROPRACTIC LLC
Entity type:Organization
Organization Name:ACHIEVE HEALTH & CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:C
Authorized Official - Last Name:WIELAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-488-9993
Mailing Address - Street 1:9968 INDIAN KEY TRL
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33776-1074
Mailing Address - Country:US
Mailing Address - Phone:727-488-9993
Mailing Address - Fax:
Practice Address - Street 1:9968 INDIAN KEY TRL
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33776-1074
Practice Address - Country:US
Practice Address - Phone:727-488-9993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005183111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty