Provider Demographics
NPI:1639357635
Name:KROL CHIROPRACTIC CENTER PA
Entity type:Organization
Organization Name:KROL CHIROPRACTIC CENTER PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KROL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-498-8005
Mailing Address - Street 1:PO BOX 8439
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33482-8439
Mailing Address - Country:US
Mailing Address - Phone:561-498-8005
Mailing Address - Fax:561-498-2222
Practice Address - Street 1:5180 W ATLANTIC AVE
Practice Address - Street 2:SUITE 123
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8103
Practice Address - Country:US
Practice Address - Phone:561-498-8005
Practice Address - Fax:561-498-2222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380231100Medicaid
FL88841Medicare PIN
FLT85907Medicare UPIN