Provider Demographics
NPI:1326927476
Name:VITALSPINE CHIROPRACTIC SANFORD LLC
Entity type:Organization
Organization Name:VITALSPINE CHIROPRACTIC SANFORD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAELENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:321-363-4727
Mailing Address - Street 1:413 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-1207
Mailing Address - Country:US
Mailing Address - Phone:321-363-4727
Mailing Address - Fax:321-233-0275
Practice Address - Street 1:413 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-1207
Practice Address - Country:US
Practice Address - Phone:321-363-4727
Practice Address - Fax:321-233-0275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty