Healthcare Provider Details

I. General information

NPI: 1376459370
Provider Name (Legal Business Name): RESTORE CHIROPRACTIC CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SANDTREE DR STE 202C
PALM BEACH GARDENS FL
33403-1538
US

IV. Provider business mailing address

932 SANCTUARY COVE DR
WEST PALM BEACH FL
33410-4517
US

V. Phone/Fax

Practice location:
  • Phone: 561-203-9650
  • Fax:
Mailing address:
  • Phone: 561-203-9650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER CUCULLU
Title or Position: SOLE MEMBER/MANAGER/OWNER
Credential: DC
Phone: 907-244-3541