MEDICARE: OPTIMIZED PRECISION 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
1	111N00000X	Chiropractor	CH11749	FL

General Provider Information

NPI Number	:	1932565413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMIZED PRECISION CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	5891 S MILITARY TRL
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-6920
Country	:	US
Telephone Number	:	561-827-2813
Fax Number	:

Provider Business Practice Location Address
First Line	:	5891 S MILITARY TRL
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-6920
Country	:	US
Telephone Number	:	561-827-2813
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NAGEEB HANNA
Credential	:	DC
Telephone Number	:	561-827-2813

Provider Enumeration Date	:	01/13/2016
Last Update Date	:	10/29/2020

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