Provider Demographics
NPI:1780915322
Name:CHIRO-MEDICAL PAIN RELIEF CENTER, INC.
Entity type:Organization
Organization Name:CHIRO-MEDICAL PAIN RELIEF CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:PELLEGRINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-367-1333
Mailing Address - Street 1:731 NE 32ND ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6918
Mailing Address - Country:US
Mailing Address - Phone:561-367-1333
Mailing Address - Fax:561-367-1320
Practice Address - Street 1:1395 W SUNRISE BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-7076
Practice Address - Country:US
Practice Address - Phone:561-367-1333
Practice Address - Fax:561-367-1320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty