Provider Demographics
NPI:1356680128
Name:BARTLETT, JUSTIN JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:JAMES
Last Name:BARTLETT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5604 PGA BLVD
Mailing Address - Street 2:SUITE C107
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3831
Mailing Address - Country:US
Mailing Address - Phone:561-625-5422
Mailing Address - Fax:561-625-5425
Practice Address - Street 1:5604 PGA BLVD
Practice Address - Street 2:SUITE C107
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-3831
Practice Address - Country:US
Practice Address - Phone:561-625-5422
Practice Address - Fax:561-625-5425
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10705111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition