Provider Demographics
NPI:1669640181
Name:GALT MILE WELLNESS CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:GALT MILE WELLNESS CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRIETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:CECCARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-564-3200
Mailing Address - Street 1:3320 NE 34TH ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-6906
Mailing Address - Country:US
Mailing Address - Phone:954-564-3200
Mailing Address - Fax:954-564-3201
Practice Address - Street 1:3320 NE 34TH ST
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-6906
Practice Address - Country:US
Practice Address - Phone:954-564-3200
Practice Address - Fax:954-564-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8404111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty