Provider Demographics
NPI:1346531480
Name:PERRY CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:PERRY CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:E
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:828-773-9018
Mailing Address - Street 1:160 W CAMINO REAL
Mailing Address - Street 2:240
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5942
Mailing Address - Country:US
Mailing Address - Phone:828-773-9018
Mailing Address - Fax:
Practice Address - Street 1:90 TILFORD E
Practice Address - Street 2:SUITE T
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-2106
Practice Address - Country:US
Practice Address - Phone:828-773-9018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2014-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty