Provider Demographics
NPI:1992016281
Name:RINEHART CHIROPRACTIC LIFE CENTER, INC
Entity Type:Organization
Organization Name:RINEHART CHIROPRACTIC LIFE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LYLE
Authorized Official - Last Name:RINEHART
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:561-844-9733
Mailing Address - Street 1:11380 PROSPERITY FARMS RD
Mailing Address - Street 2:SUITE 110B
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3474
Mailing Address - Country:US
Mailing Address - Phone:561-844-9733
Mailing Address - Fax:561-249-3172
Practice Address - Street 1:11380 PROSPERITY FARMS RD
Practice Address - Street 2:SUITE 110B
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3474
Practice Address - Country:US
Practice Address - Phone:561-844-9733
Practice Address - Fax:561-249-3172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3526111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT85868Medicare UPIN
FL88530Medicare PIN