Provider Demographics
NPI:1619903259
Name:FIRST CHOICE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:FIRST CHOICE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLERGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-296-8787
Mailing Address - Street 1:200 BUTLER ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-6036
Mailing Address - Country:US
Mailing Address - Phone:561-296-8787
Mailing Address - Fax:561-296-8788
Practice Address - Street 1:200 BUTLER ST
Practice Address - Street 2:SUITE 301
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-6036
Practice Address - Country:US
Practice Address - Phone:561-296-8787
Practice Address - Fax:561-296-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8493111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89634Medicare ID - Type Unspecified