Provider Demographics
NPI:1245615343
Name:INJURY CLINC & REHAB CENTER
Entity Type:Organization
Organization Name:INJURY CLINC & REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AYAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-687-5150
Mailing Address - Street 1:1229 NORTH MILITARY TRAIL #6
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6059
Mailing Address - Country:US
Mailing Address - Phone:561-687-5150
Mailing Address - Fax:561-687-5051
Practice Address - Street 1:1229 NORTH MILITARY TRAIL #6
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6059
Practice Address - Country:US
Practice Address - Phone:561-687-5150
Practice Address - Fax:561-687-5051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9798111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Multi-Specialty