Provider Demographics
NPI:1770605883
Name:SUNSHINE CHIROPRACTIC LIFE CENTRE WEST PA
Entity type:Organization
Organization Name:SUNSHINE CHIROPRACTIC LIFE CENTRE WEST PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:YOHAM
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:305-829-2355
Mailing Address - Street 1:8543 N.W. 186 ST.
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2557
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8543 N.W. 186 ST.
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-2557
Practice Address - Country:US
Practice Address - Phone:305-829-2355
Practice Address - Fax:305-829-2231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005878111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty