Provider Demographics
NPI:1376549782
Name:CHERLOW, BRUCE J (DC)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:J
Last Name:CHERLOW
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 1:6662 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-1694
Mailing Address - Country:US
Mailing Address - Phone:954-796-0060
Mailing Address - Fax:954-340-8925
Practice Address - Street 1:6662 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-1694
Practice Address - Country:US
Practice Address - Phone:954-796-0060
Practice Address - Fax:954-340-8925
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5233111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380350300Medicaid
T77520Medicare UPIN
FL22277Medicare PIN