Healthcare Provider Details

I. General information

NPI: 1194047928
Provider Name (Legal Business Name): HEALTH-FIT CHIROPRACTIC & SPORTS MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2010
Last Update Date: 02/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N MILITARY TRL STE 230
BOCA RATON FL
33431-6365
US

IV. Provider business mailing address

2900 N MILITARY TRL STE 230
BOCA RATON FL
33431-6365
US

V. Phone/Fax

Practice location:
  • Phone: 561-859-3109
  • Fax: 561-988-8993
Mailing address:
  • Phone: 561-859-3109
  • Fax: 561-988-8993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCH9169
License Number StateFL

VIII. Authorized Official

Name: DR. KEVIN MATTHEW CHRISTIE II
Title or Position: OWNER/PHYSICIAN
Credential: D.C.
Phone: 561-859-3109