Provider Demographics
NPI:1558474502
Name:ROYAL PALM CHIROPRACTIC & REHAB CENTER P.A.
Entity Type:Organization
Organization Name:ROYAL PALM CHIROPRACTIC & REHAB CENTER P.A.
Other - Org Name:ROYAL PALM CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORINELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-383-8080
Mailing Address - Street 1:1188 ROYAL PALM BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1672
Mailing Address - Country:US
Mailing Address - Phone:561-383-8080
Mailing Address - Fax:561-383-8060
Practice Address - Street 1:1188 ROYAL PALM BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1672
Practice Address - Country:US
Practice Address - Phone:561-383-8080
Practice Address - Fax:561-383-8060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID NUMBER