Provider Demographics
NPI:1992204309
Name:CORRECTIVE CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:CORRECTIVE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:BOWERS
Authorized Official - Last Name:HASLETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-247-0044
Mailing Address - Street 1:420 S STATE ROAD 7 STE 170
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4306
Mailing Address - Country:US
Mailing Address - Phone:561-247-0044
Mailing Address - Fax:
Practice Address - Street 1:420 S STATE ROAD 7 STE 170
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33414
Practice Address - Country:US
Practice Address - Phone:561-247-0044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12296261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center