Healthcare Provider Details

I. General information

NPI: 1487841219
Provider Name (Legal Business Name): TANG HOLISTIC CHIROPRACTIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 04/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2889 10TH AVE N SUITE 303
PALM SPRINGS FL
33461-3045
US

IV. Provider business mailing address

2889 10TH AVE N SUITE 303
PALM SPRINGS FL
33461-3045
US

V. Phone/Fax

Practice location:
  • Phone: 561-296-6866
  • Fax: 561-296-6869
Mailing address:
  • Phone: 561-296-6866
  • Fax: 561-296-6869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberCH8478
License Number StateFL

VIII. Authorized Official

Name: DR. HUI WEN TANG
Title or Position: DR.
Credential: D.C.
Phone: 561-296-6866