Provider Demographics
NPI:1619205697
Name:BIXON CHIROPRACTIC CENTER, PA
Entity type:Organization
Organization Name:BIXON CHIROPRACTIC CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:T
Authorized Official - Last Name:BIXON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-834-2225
Mailing Address - Street 1:242 W HWY 434
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750
Mailing Address - Country:US
Mailing Address - Phone:407-834-2225
Mailing Address - Fax:407-834-8564
Practice Address - Street 1:434 W HWY 434
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750
Practice Address - Country:US
Practice Address - Phone:407-834-2225
Practice Address - Fax:407-834-8564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380151900Medicaid
FL380151900Medicaid