Provider Demographics
NPI:1952453227
Name:KATHY JO PANSEGRAU DC INC
Entity Type:Organization
Organization Name:KATHY JO PANSEGRAU DC INC
Other - Org Name:360 DEGREES OF HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:PANSEGRAU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-782-8200
Mailing Address - Street 1:750 E SAMPLE RD
Mailing Address - Street 2:BUILDING 3 SUITE 1
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-5144
Mailing Address - Country:US
Mailing Address - Phone:954-782-8200
Mailing Address - Fax:954-782-8909
Practice Address - Street 1:750 E SAMPLE RD
Practice Address - Street 2:BUILDING 3 SUITE 1
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-5144
Practice Address - Country:US
Practice Address - Phone:954-782-8200
Practice Address - Fax:954-782-8909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8430111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty