Provider Demographics
NPI:1760424527
Name:CHANG, JOEY BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOEY
Middle Name:BRIAN
Last Name:CHANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 NE JENSEN BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-7233
Mailing Address - Country:US
Mailing Address - Phone:772-334-1377
Mailing Address - Fax:772-334-1391
Practice Address - Street 1:1803 NE JENSEN BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-7233
Practice Address - Country:US
Practice Address - Phone:772-334-1377
Practice Address - Fax:772-334-1391
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8405111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL64015ZMedicare PIN