Provider Demographics
NPI:1073711263
Name:MODERN CHIROPRACTIC CENTER OF DELRAY PA
Entity Type:Organization
Organization Name:MODERN CHIROPRACTIC CENTER OF DELRAY PA
Other - Org Name:DR. PETER VAPNEK CHIROPRACTIC AND MASSAGE THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-702-4914
Mailing Address - Street 1:1050 S FEDERAL HWY STE 145
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5192
Mailing Address - Country:US
Mailing Address - Phone:561-274-6100
Mailing Address - Fax:561-278-2399
Practice Address - Street 1:1050 S FEDERAL HWY STE 145
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5192
Practice Address - Country:US
Practice Address - Phone:561-274-6100
Practice Address - Fax:561-278-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6861111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty