Provider Demographics
NPI:1750348223
Name:HEDGLON CHIROPRACTIC CENTER INC
Entity type:Organization
Organization Name:HEDGLON CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HEDGLON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-946-1799
Mailing Address - Street 1:1313 E SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6244
Mailing Address - Country:US
Mailing Address - Phone:954-946-1799
Mailing Address - Fax:954-946-7801
Practice Address - Street 1:1313 E SAMPLE RD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-6244
Practice Address - Country:US
Practice Address - Phone:954-946-1799
Practice Address - Fax:954-946-7801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005123111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22225OtherBLUE CROSS BLUE SHIELD
FL22225Medicare PIN