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General NPI Number Information
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NPI Number | 1114871464
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Entity Type | Organization
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Legal Business Name | MODERN CHIRO WELLNESS1
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Dates
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Enumeration Date | 02/24/2026
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 2704 W ATLANTIC BLVD
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City | POMPANO BEACH
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State | FL
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Zip | 33069-2551
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Country | US
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Telephone | 954-586-4868
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Fax | 954-586-4868
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Provider Business Mailing Address
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Address Line | 2704 W ATLANTIC BLVD
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City | POMPANO BEACH
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State | FL
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Zip | 33069-2551
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Country | US
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Telephone | 954-586-4868
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Fax | 954-586-4868
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Authorized Official
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Title or Position | MANAGER
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Name | JUSTIN PLUNKETT
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Credential | DC
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Telephone | 561-935-7715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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