Healthcare Provider Details
I. General information
NPI: 1427405927
Provider Name (Legal Business Name): KAHOOK CHIROPRACTIC AND WELLNESS CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/16/2016
Last Update Date: 06/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
409 S DIXIE HWY
LAKE WORTH FL
33460-4442
US
IV. Provider business mailing address
1701 MANGO CIR
LAKE CLARKE SHORES FL
33406-5258
US
V. Phone/Fax
- Phone: 561-582-5433
- Fax: 561-585-0074
- Phone: 561-261-4242
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | CH |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
KATRINA
KAHOOK
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 561-261-4242