| West Bay Chiropractic | |
|
8730 Fountain Ave Tampa FL 33615-2802 | |
| (813) 885-6001 | |
| (813) 885-6874 |
| Full Name | West Bay Chiropractic |
|---|---|
| Speciality | Clinic/Center |
| Location | 8730 Fountain Ave, Tampa, Florida |
| Authorized Official Name and Position | William Lichter (PRESIDENT) |
| Authorized Official Contact | 8138856001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Bay Chiropractic 8730 Fountain Ave Tampa FL 33615-2802 Ph: (813) 885-6001 | West Bay Chiropractic 8730 Fountain Ave Tampa FL 33615-2802 Ph: (813) 885-6001 |
| NPI Number | 1285714394 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 04/01/2013 |
| Medicare PECOS PAC ID | 1850538901 |
|---|---|
| Medicare Enrollment ID | O20130508000363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285714394 | NPI | - | NPPES |
| 380716900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | CH6815 (Florida) | Primary |
| Provider Name | William I Lichter |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1396704250 PECOS PAC ID: 5294831103 Enrollment ID: I20070509000124 |
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