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General NPI Number Information
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NPI Number | 1245414812
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Entity Type | Organization
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Legal Business Name | SPINAL HEALTH PERFORMANCE, INC.
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Dates
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Enumeration Date | 12/19/2007
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 603 VILLAGE BLVD STE 303
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-1973
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Country | US
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Telephone | 561-684-9200
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Fax | 561-684-9202
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Provider Business Mailing Address
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Address Line | 603 VILLAGE BLVD STE 303
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-1973
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Country | US
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Telephone | 561-684-9200
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Fax | 561-684-9202
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. R. KEVIN O'BRIEN
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Credential | DC
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Telephone | 561-684-9200
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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 | CH7447
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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