Healthcare Provider Details

I. General information

NPI: 1235744186
Provider Name (Legal Business Name): EMMA LOUISE HULBURD DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 09/08/2020
Certification Date: 09/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 PALM BEACH LAKES BLVD STE 1200
WEST PALM BEACH FL
33401-2214
US

IV. Provider business mailing address

1645 PALM BEACH LAKES BLVD STE 1200
WEST PALM BEACH FL
33401-2214
US

V. Phone/Fax

Practice location:
  • Phone: 561-207-2077
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH12964
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: