Provider Demographics
NPI:1396941308
Name:VILLAGE CHIROPRACTIC CENTER OF BOYNTON BEACH INC
Entity type:Organization
Organization Name:VILLAGE CHIROPRACTIC CENTER OF BOYNTON BEACH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:WASSER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-733-7772
Mailing Address - Street 1:6607 BOYNTON BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3526
Mailing Address - Country:US
Mailing Address - Phone:561-733-7772
Mailing Address - Fax:561-733-9338
Practice Address - Street 1:6607 BOYNTON BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3526
Practice Address - Country:US
Practice Address - Phone:561-733-7772
Practice Address - Fax:561-733-9338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty