Provider Demographics
NPI:1215228184
Name:WENZEL CENTER FOR CHIROPRACTIC & ALTERNATIVE MEDICINE,INC
Entity Type:Organization
Organization Name:WENZEL CENTER FOR CHIROPRACTIC & ALTERNATIVE MEDICINE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRE
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WENZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-955-9400
Mailing Address - Street 1:123 E PALMETTO PARK RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-4818
Mailing Address - Country:US
Mailing Address - Phone:561-955-9400
Mailing Address - Fax:561-955-1988
Practice Address - Street 1:123 E PALMETTO PARK RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-4818
Practice Address - Country:US
Practice Address - Phone:561-955-9400
Practice Address - Fax:561-955-1988
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-27
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7189111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU69738Medicare UPIN