Provider Demographics
NPI:1427382936
Name:GENTLE CHIROPRACTIC OFFICES, INC.
Entity Type:Organization
Organization Name:GENTLE CHIROPRACTIC OFFICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:772-335-3222
Mailing Address - Street 1:1696 SE HILLMOOR DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7699
Mailing Address - Country:US
Mailing Address - Phone:772-335-3222
Mailing Address - Fax:772-335-3793
Practice Address - Street 1:1696 SE HILLMOOR DR
Practice Address - Street 2:SUITE C
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7699
Practice Address - Country:US
Practice Address - Phone:772-335-3222
Practice Address - Fax:772-335-3793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5283111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty