Healthcare Provider Details

I. General information

NPI: 1033224548
Provider Name (Legal Business Name): JEFFREY L STANGER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 08/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N CONGRESS AVE SUITE 417
DELRAY BEACH FL
33445-4621
US

IV. Provider business mailing address

601 N CONGRESS AVE SUITE 417
DELRAY BEACH FL
33445-4621
US

V. Phone/Fax

Practice location:
  • Phone: 561-498-4300
  • Fax: 561-498-4539
Mailing address:
  • Phone: 561-498-4300
  • Fax: 561-498-4539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH3463
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: