Provider Demographics
NPI:1518034172
Name:PHILISTIN, OSLY (DC)
Entity Type:Individual
Prefix:
First Name:OSLY
Middle Name:
Last Name:PHILISTIN
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 1:1712 ANNANDALE CIR
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-6103
Mailing Address - Country:US
Mailing Address - Phone:561-271-6061
Mailing Address - Fax:561-899-3180
Practice Address - Street 1:1962 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6674
Practice Address - Country:US
Practice Address - Phone:561-819-6500
Practice Address - Fax:516-819-6502
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9111111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor