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NPI Code Detail

MEDICARE: EMPIRE CHIROPRACTIC LLC

MEDICARE: EMPIRE CHIROPRACTIC LLC
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
1111N00000XChiropractor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PENDINGOTHERFLPENDING

General Provider Information

NPI Number : 1659831485
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMPIRE CHIROPRACTIC LLC
Provider Business Mailing Address
First Line : 4915 S CONGRESS AVE STE B
Second Line :
City : PALM SPRINGS
State : FL
Zip : 33461-4734
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4915 S CONGRESS AVE # 3B
Second Line :
City : PALM SPRINGS
State : FL
Zip : 33461-4734
Country : US
Telephone Number : 786-269-7682
Fax Number :
Authorized Official
Title or Position : OWNER
Name : OSLY PHILISTIN
Credential : DC
Telephone Number : 561-271-6061
Provider Enumeration Date : 03/19/2019
Last Update Date : 03/19/2019

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Directions to “EMPIRE CHIROPRACTIC LLC ” Practice Location

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