Provider Demographics
NPI:1972054625
Name:ROBERT A DEMETREE DC, INC
Entity type:Organization
Organization Name:ROBERT A DEMETREE DC, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMETREE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-862-7272
Mailing Address - Street 1:797 N STATE ROAD 434
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-7233
Mailing Address - Country:US
Mailing Address - Phone:407-862-7272
Mailing Address - Fax:407-862-6444
Practice Address - Street 1:797 N STATE ROAD 434
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-7233
Practice Address - Country:US
Practice Address - Phone:407-862-7272
Practice Address - Fax:407-862-6444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty