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General NPI Number Information
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NPI Number | 1134591456
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Entity Type | Organization
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Legal Business Name | BROWARD PAIN AND WELLNESS INC
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 2745 E ATLANTIC BLVD SITE302
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City | POMPANO BEACH
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State | FL
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Zip | 33062-4952
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Country | US
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Telephone | 954-960-2227
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Fax |
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Provider Business Mailing Address
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Address Line | 2673 E. ATLANTIC BLVD. #145
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City | POMPANO BEACH
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State | FL
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Zip | 33062
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Country | US
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Telephone | 786-252-3397
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Fax | 800-298-7337
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. LARRY FRYDMAN II
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Credential | DC
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Telephone | 786-252-3397
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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 | CH10780
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License Number State | FL
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