Provider Demographics
NPI:1508360355
Name:WASSERMAN CHIROPRACTIC OF PALM BEACH, LLC
Entity Type:Organization
Organization Name:WASSERMAN CHIROPRACTIC OF PALM BEACH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:WASSERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-242-4075
Mailing Address - Street 1:1731 S PALMWAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-5843
Mailing Address - Country:US
Mailing Address - Phone:954-242-2739
Mailing Address - Fax:
Practice Address - Street 1:2151 S HIGHWAY A1A ALT STE 600
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-4064
Practice Address - Country:US
Practice Address - Phone:561-747-5234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty