Healthcare Provider Details

I. General information

NPI: 1942328299
Provider Name (Legal Business Name): DMX IMAGING OF THE PALM BEACHES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 S CONGRESS AVE
LAKE WORTH FL
33461-2111
US

IV. Provider business mailing address

3015 S CONGRESS AVE
LAKE WORTH FL
33461-2111
US

V. Phone/Fax

Practice location:
  • Phone: 561-433-4184
  • Fax: 561-433-1284
Mailing address:
  • Phone: 561-433-4184
  • Fax: 561-433-1284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License NumberCH7829
License Number StateFL

VIII. Authorized Official

Name: DR. H. GLENN CORKINS
Title or Position: PRESIDENT
Credential: DC, PHD, NMD
Phone: 561-296-5182