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General NPI Number Information
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NPI Number | 1043621337
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Entity Type | Organization
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Legal Business Name | PHYSICIAN'S LABORATORY, INC.
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Dates
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Enumeration Date | 05/08/2014
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Last Update Date | 05/08/2014
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Provider Practice Location Address
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Address Line | 200 KNUTH RD SUITE 230
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-4629
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Country | US
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Telephone | 561-777-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 1570 SW 16TH ST
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City | BOCA RATON
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State | FL
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Zip | 33486-6535
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ANN WILLIAMS
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Credential |
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Telephone | 561-715-7373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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