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General NPI Number Information
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NPI Number | 1194260372
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Entity Type | Organization
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Legal Business Name | BRODKIN CHIROPRACTIC AND ACUPUNCTURE
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Dates
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Enumeration Date | 12/27/2016
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Last Update Date | 12/27/2016
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Provider Practice Location Address
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Address Line | 7805 NW BEACON SQUARE BLVD SUITE 103
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City | BOCA RATON
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State | FL
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Zip | 33487-1395
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Country | US
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Telephone | 561-620-0174
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Fax | 561-988-2125
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Provider Business Mailing Address
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Address Line | 7805 NW BEACON SQUARE BLVD SUITE 103
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City | BOCA RATON
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State | FL
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Zip | 33487-1395
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Country | US
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Telephone | 561-620-0174
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Fax | 561-988-2125
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Authorized Official
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Title or Position | CHIROPRACTIC NEUROLOGIST
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Name | DR. RONALD A BRODKIN
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Credential | DC,DIBCN,DIBE,FIACN
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Telephone | 561-620-0174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | CH4412
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License Number State | FL
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