Provider Demographics
NPI:1811215783
Name:PREFERRED CHIROPRACTIC LLC
Entity type:Organization
Organization Name:PREFERRED CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:PREFER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-691-6202
Mailing Address - Street 1:3309 NORTHLAKE BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33403-1705
Mailing Address - Country:US
Mailing Address - Phone:561-691-6202
Mailing Address - Fax:561-691-6202
Practice Address - Street 1:3309 NORTHLAKE BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33403-1705
Practice Address - Country:US
Practice Address - Phone:561-691-6202
Practice Address - Fax:561-691-6202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-17
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHQ503AMedicare PIN