MEDICARE: MY BODYWORX CHIROPRACTIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1619790599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY BODYWORX CHIROPRACTIC

Provider Business Mailing Address
First Line	:	14560 S MILITARY TRL STE B4
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-3794
Country	:	US
Telephone Number	:	561-926-9494
Fax Number	:

Provider Business Practice Location Address
First Line	:	14560 S MILITARY TRL STE B4
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-3794
Country	:	US
Telephone Number	:	561-926-9494
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JONATHAN SEGAL
Credential	:
Telephone Number	:	561-926-9494

Provider Enumeration Date	:	11/07/2024
Last Update Date	:	11/07/2024

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