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General NPI Number Information
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NPI Number | 1083905376
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Entity Type | Organization
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Legal Business Name | NU LOOK REHAB INC
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Dates
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Enumeration Date | 04/21/2011
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 190 NE 199TH ST SUITE 203
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City | MIAMI
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State | FL
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Zip | 33179-2927
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Country | US
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Telephone | 305-493-8734
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Fax | 305-651-2608
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Provider Business Mailing Address
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Address Line | 190 NE 199TH ST SUITE 104
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City | MIAMI
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State | FL
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Zip | 33179-2927
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Country | US
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Telephone | 786-323-8189
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Fax | 305-651-2608
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DAVID JAMES KIDD
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Credential | DC
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Telephone | 305-493-8734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | CH7050
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License Number State | FL
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