Provider Demographics
NPI:1821274762
Name:FOX CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:FOX CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-650-1205
Mailing Address - Street 1:3030 S DIXIE HWY STE 4
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-1539
Mailing Address - Country:US
Mailing Address - Phone:561-650-1205
Mailing Address - Fax:561-650-1206
Practice Address - Street 1:3030 S DIXIE HWY STE 4
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-1539
Practice Address - Country:US
Practice Address - Phone:561-650-1205
Practice Address - Fax:561-650-1206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5169OtherMEDICARE GROUP ID NUMBER
FLU1954ZMedicare PIN
FLU83726Medicare UPIN