Provider Demographics
NPI:1679901045
Name:ORLANDO CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:ORLANDO CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:ORLANDO
Authorized Official - Last Name:II
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-228-5324
Mailing Address - Street 1:267 BLOOR ST
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-2016
Mailing Address - Country:US
Mailing Address - Phone:440-228-5324
Mailing Address - Fax:
Practice Address - Street 1:167 W MAIN RD
Practice Address - Street 2:SUITE A
Practice Address - City:CONNEAUT
Practice Address - State:OH
Practice Address - Zip Code:44030-2057
Practice Address - Country:US
Practice Address - Phone:440-593-7788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC4315111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty