Provider Demographics
NPI:1659363547
Name:QUARTELL CHIROPRACTIC
Entity Type:Organization
Organization Name:QUARTELL CHIROPRACTIC
Other - Org Name:QUARTELL CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:QUARTELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-625-5556
Mailing Address - Street 1:7100 FAIRWAY DR
Mailing Address - Street 2:STE 33
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3777
Mailing Address - Country:US
Mailing Address - Phone:561-625-5556
Mailing Address - Fax:561-625-4622
Practice Address - Street 1:7100 FAIRWAY DR
Practice Address - Street 2:STE 33
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-3777
Practice Address - Country:US
Practice Address - Phone:561-625-5556
Practice Address - Fax:561-625-4622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7713111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
55945Medicare ID - Type Unspecified
=========Medicare UPIN