Advanced Spine and Wellness
Organization Active NPI Neurology Chiropractor · Winter Haven, FL
NPI 1154736866 · NPPES record last updated Jun 23, 2014
Key facts
- NPI
- 1154736866
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Neurology Chiropractor 111NN0400X
- License
- CH9923 (FL)
- Legal business name
- ADVANCED SPINE AND WELLNESS
- Practice address
- 1125 1St St S
Winter Haven, FL 33880-3902 - Phone
- (863) 293-0040
- NPI assigned
- Jun 23, 2014
- Organization subpart
- No
Authorized official
- Name
- Clark Lemmon, D.C.
- Title
- President
- Phone
- (863) 293-0040
Practitioners 1
-
Clark Jeffrey Lemmon, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101116000056 | FL | Part B Supplier - Clinic/Group Practice | 1850586868 |
Receives reassigned benefits from 1 practitioner Practice locations: Winter Haven, FL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Chiropractor |
111NN0400X | CH9923 | FL | Yes |
Addresses
Primary practice location
1125 1St St S
Winter Haven, FL 33880-3902
Mailing address
1125 1St St S
Winter Haven, FL 33880-3902
Phone (863) 293-0040
Other providers in Winter Haven, FL
- Advance Rehab Clinic, Inc
- Advance Technological Radiology, PA
- Advanced Orthopedic Surgery
- Advanced Orthopedic Surgery of Celebration, LLC
- Advanced Rehab Clinic of Winter Haven
- Advanced Spine and Wellness
- Vriti Advani
- Adventhealth Bond Clinic, Inc.
- Adventhealth Bond Clinic, Inc.
- Adventhealth Bond Clinic, Inc.
All providers in Winter Haven, FL · Neurology Chiropractor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.