Provider Demographics
NPI:1598366684
Name:NEW HEALTH CHIROPRACTIC WELLNESS CENTER
Entity Type:Organization
Organization Name:NEW HEALTH CHIROPRACTIC WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GERVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-658-1319
Mailing Address - Street 1:2695 N MILITARY TRL STE 17
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-2946
Mailing Address - Country:US
Mailing Address - Phone:561-658-1319
Mailing Address - Fax:863-576-9953
Practice Address - Street 1:2695 N MILITARY TRL STE 17
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-2946
Practice Address - Country:US
Practice Address - Phone:561-658-1319
Practice Address - Fax:863-576-9953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1578712220OtherNPI
FL1174553606OtherNPI