Provider Demographics
NPI:1942856190
Name:SIPE CHIROPRACTIC AND REHABILITATION, LLC
Entity Type:Organization
Organization Name:SIPE CHIROPRACTIC AND REHABILITATION, LLC
Other - Org Name:SIPE SPINE AND SPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SIPE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-705-1085
Mailing Address - Street 1:1050 NW 15TH ST STE 102A
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1341
Mailing Address - Country:US
Mailing Address - Phone:561-705-1085
Mailing Address - Fax:561-807-8459
Practice Address - Street 1:1050 NW 15TH ST STE 102A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1341
Practice Address - Country:US
Practice Address - Phone:561-705-1085
Practice Address - Fax:561-807-8459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty