Provider Demographics
NPI:1336502061
Name:PALM BEACH CHIROPRACTIC & REHABILITATION INC
Entity Type:Organization
Organization Name:PALM BEACH CHIROPRACTIC & REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:LAMPERSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-345-1916
Mailing Address - Street 1:5500 S STATE ROAD 7
Mailing Address - Street 2:SUITE 112
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33449-5451
Mailing Address - Country:US
Mailing Address - Phone:561-708-5700
Mailing Address - Fax:561-708-5750
Practice Address - Street 1:5500 S STATE ROAD 7
Practice Address - Street 2:SUITE 112
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33449-5451
Practice Address - Country:US
Practice Address - Phone:561-708-5700
Practice Address - Fax:561-708-5750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIP448AMedicare PIN