Organization
BOLICK CLINIC, INC.
Active
Other names
The Bolick Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHANNING C BOLICK DC (PRESIDENT)
(407) 629-5333
Entity
Organization
Contact information
Practice address
500 E HORATIO AVE STE 5, MAITLAND, FL 32751-7310
(407) 629-5333
(407) 629-5343
Mailing address
500 E HORATIO AVE STE 5, MAITLAND, FL 32751-7310
(407) 629-5333
(407) 629-5343
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
171100000X
Acupuncturist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3819132-00
—
FL
01
—
55996
BLUE CROSS GROUP NUMBER
FL
Enumeration date
11/29/2006
Last updated
09/23/2025
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