Provider Demographics
NPI:1114194701
Name:CHIROPRACTIC-WORKS LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC-WORKS LLC
Other - Org Name:HEALING HANDS OF BOCA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:PENNINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-391-8446
Mailing Address - Street 1:1943 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-1934
Mailing Address - Country:US
Mailing Address - Phone:561-391-8446
Mailing Address - Fax:561-391-8443
Practice Address - Street 1:1943 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1934
Practice Address - Country:US
Practice Address - Phone:561-391-8446
Practice Address - Fax:561-391-8443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7611111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001512400Medicaid
FL001512400Medicaid