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General NPI Number Information
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NPI Number | 1245424134
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Entity Type | Organization
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Legal Business Name | SYNERGY CHIROPRACTIC & WELLNESS CENTER INC
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 09/04/2007
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Provider Practice Location Address
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Address Line | 601 E 49TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-1963
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Country | US
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Telephone | 305-688-9732
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Fax | 305-688-9435
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Provider Business Mailing Address
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Address Line | 601 E 49TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-1963
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Country | US
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Telephone | 305-688-9732
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Fax | 305-688-9435
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Authorized Official
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Title or Position | PRESIDENT
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Name | TANYA R KAHL
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Credential | DC
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Telephone | 305-688-9732
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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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