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General NPI Number Information
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NPI Number | 1154876811
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Entity Type | Organization
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Legal Business Name | ESSENTIAL HEALTH OF WESTON
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 08/23/2016
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Provider Practice Location Address
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Address Line | 15830 W STATE ROAD 84
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City | SUNRISE
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State | FL
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Zip | 33326-1212
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Country | US
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Telephone | 954-389-5507
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Fax |
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Provider Business Mailing Address
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Address Line | 15830 W STATE ROAD 84
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City | SUNRISE
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State | FL
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Zip | 33326-1212
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Country | US
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Telephone | 954-389-5507
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN FERGANG
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Credential |
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Telephone | 954-389-5507
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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 | CH0005597
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License Number State | FL
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