Provider Demographics
NPI:1902124399
Name:URMOS CHIROPRACTIC HEALTH CENTER PA
Entity Type:Organization
Organization Name:URMOS CHIROPRACTIC HEALTH CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:URMOS
Authorized Official - Suffix:
Authorized Official - Credentials:BS, DC, CCSP
Authorized Official - Phone:850-932-3565
Mailing Address - Street 1:PO BOX 5757
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-0757
Mailing Address - Country:US
Mailing Address - Phone:850-932-3565
Mailing Address - Fax:850-932-3566
Practice Address - Street 1:2870 GULF BREEZE PKWY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-3146
Practice Address - Country:US
Practice Address - Phone:850-932-3565
Practice Address - Fax:850-932-3566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-10
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6535111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22927OtherPTAN