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Organization
SOUTHERN TRACE CHIROPRACTIC AND MASSAGE CENTER PA
Active
Organization
SOUTHERN TRACE CHIROPRACTIC AND MASSAGE CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE MARIE ZIELECKI DC (PRES)
(352) 205-8500
Entity
Organization
Contact information
Practice address
11834 COUNTY ROAD 101, SUITE 202, THE VILLAGES, FL 32162-9340
(352) 205-8500
(352) 205-8603
Mailing address
PO BOX 507, BELLEVIEW, FL 34421-0507
(352) 205-8500
(352) 205-8603
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH 7914
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000V2
BCBS
FL
01
—
DS0741
RR MEDICARE
FL
Enumeration date
06/03/2010
Last updated
10/30/2014
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