Provider Demographics
NPI:1033558648
Name:ROBERT E WALSH RPT, D.C. P.A
Entity Type:Organization
Organization Name:ROBERT E WALSH RPT, D.C. P.A
Other - Org Name:WALSH WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-525-2225
Mailing Address - Street 1:416 SE 11TH CT
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1144
Mailing Address - Country:US
Mailing Address - Phone:954-525-2225
Mailing Address - Fax:954-525-1807
Practice Address - Street 1:416 SE 11TH CT
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1144
Practice Address - Country:US
Practice Address - Phone:954-525-2225
Practice Address - Fax:954-525-1807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty