Provider Demographics
NPI:1245554393
Name:DEERFIELD BEACH PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:DEERFIELD BEACH PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-967-8888
Mailing Address - Street 1:PO BOX 20966
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33416-0966
Mailing Address - Country:US
Mailing Address - Phone:561-967-8888
Mailing Address - Fax:561-641-8303
Practice Address - Street 1:700 S FEDERAL HWY
Practice Address - Street 2:SUITE C
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-5786
Practice Address - Country:US
Practice Address - Phone:954-571-1858
Practice Address - Fax:954-421-1048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9016111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty