Provider Demographics
NPI:1275881724
Name:ALAN DAUTCH. PA
Entity Type:Organization
Organization Name:ALAN DAUTCH. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAUTCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-988-1022
Mailing Address - Street 1:2295 NW CORPORATE BLVD
Mailing Address - Street 2:SUITE 144
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7373
Mailing Address - Country:US
Mailing Address - Phone:561-988-1022
Mailing Address - Fax:
Practice Address - Street 1:3375 BURNS RD
Practice Address - Street 2:SUITE 108
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4349
Practice Address - Country:US
Practice Address - Phone:561-640-0355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALAN DAUTCH, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7578111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty