Healthcare Provider Details

I. General information

NPI: 1962703405
Provider Name (Legal Business Name): INDUSTRIAL HEALTH SOLUTIONS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2010
Last Update Date: 11/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SE DIXIE HWY SUITE 2
STUART FL
34994
US

IV. Provider business mailing address

11764 SW VALENCIA CT
PALM CITY FL
34990
US

V. Phone/Fax

Practice location:
  • Phone: 772-287-7701
  • Fax: 772-220-4473
Mailing address:
  • Phone: 772-285-2133
  • Fax: 772-219-8113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License NumberP96000078922
License Number StateFL

VIII. Authorized Official

Name: DR. BRUCE ALAN HANSBROUGH SR.
Title or Position: PRESIDENT/DIRECTOR
Credential: D.C.
Phone: 772-285-2133