Provider Demographics
NPI:1366170771
Name:EAST COAST FAMILY CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:EAST COAST FAMILY CHIROPRACTIC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER/AO
Authorized Official - Prefix:DR
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LINDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-830-3440
Mailing Address - Street 1:4220 VALLEY RIDGE BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32081-5173
Mailing Address - Country:US
Mailing Address - Phone:904-217-0361
Mailing Address - Fax:
Practice Address - Street 1:4220 VALLEY RIDGE BLVD STE 106
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32081-5173
Practice Address - Country:US
Practice Address - Phone:904-217-0361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-12
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty