PROGRESSIVE CHIROPRACTIC AND REHABILITATION NPI 1053730218

NPI Information

NPI: 1053730218
Provider Name: PROGRESSIVE CHIROPRACTIC AND REHABILITATION
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
502 S MAIN ST
CRESTVIEW, FL
ZIP 32536
Phone: (850) 398-8640
Get Directions

PROGRESSIVE CHIROPRACTIC AND REHABILITATION is a chiropractor in Crestview, FL. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. PROGRESSIVE CHIROPRACTIC AND REHABILITATION NPI is 1053730218. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

502 S MAIN ST
CRESTVIEW, FL
ZIP 32536-250
Phone: (850) 398-8640
Fax: (850) 398-8641

The provider's authorized official is Joel A. Tate .
The authorized official title is Chiropractic Physician/owner and has the following contact phone number (309) 830-9694.

The enumeration date for this NPI number is 4/15/2014 and was last updated on 4/15/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor		CH9929	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	220C0	OTHER	FLORIDA	BLUE CROSS BLUE SHIELD PROVIDER NUMBER
2	CH9929	OTHER	FLORIDA	MEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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