Provider Demographics
NPI:1427187616
Name:TREASURE COAST FAMILY WELLNESS LLC
Entity Type:Organization
Organization Name:TREASURE COAST FAMILY WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:T
Authorized Official - Last Name:JOCHUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-692-7636
Mailing Address - Street 1:2835 NW FEDERAL HWY
Mailing Address - Street 2:STE A
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-9252
Mailing Address - Country:US
Mailing Address - Phone:772-692-7636
Mailing Address - Fax:772-692-7637
Practice Address - Street 1:2835 NW FEDERAL HWY
Practice Address - Street 2:STE A
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-9252
Practice Address - Country:US
Practice Address - Phone:772-692-7636
Practice Address - Fax:772-692-7637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9098111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty