Provider Demographics
NPI:1992911200
Name:ADVANCE CHIROPRACTIC ADJUSTMENT, INC.
Entity type:Organization
Organization Name:ADVANCE CHIROPRACTIC ADJUSTMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE-RUTHE
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-521-0677
Mailing Address - Street 1:3643 WIMBLEDON LN
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-8698
Mailing Address - Country:US
Mailing Address - Phone:863-521-0677
Mailing Address - Fax:
Practice Address - Street 1:280 PATTERSON RD STE 2
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-6261
Practice Address - Country:US
Practice Address - Phone:863-421-8687
Practice Address - Fax:863-421-8670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC7316OtherHEALTH CARE CLINIC