Provider Demographics
NPI:1245721620
Name:FUNCTIONAL HEALTH PLANNING, LLC
Entity type:Organization
Organization Name:FUNCTIONAL HEALTH PLANNING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DACNB
Authorized Official - Phone:352-571-5155
Mailing Address - Street 1:1000 MAIN STREET
Mailing Address - Street 2:MVP ATHLETIC CLUB, #237
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159
Mailing Address - Country:US
Mailing Address - Phone:352-571-5155
Mailing Address - Fax:352-633-1396
Practice Address - Street 1:1000 MAIN STREET
Practice Address - Street 2:MVP ATHLETIC CLUB, #237
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159
Practice Address - Country:US
Practice Address - Phone:352-571-5155
Practice Address - Fax:352-633-1396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10093111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty