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General NPI Number Information
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NPI Number | 1245655208
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Entity Type | Organization
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Legal Business Name | SPICUZZO CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 02/27/2014
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Last Update Date | 05/13/2014
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Provider Practice Location Address
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Address Line | 100 S MILITARY TRL STE 18
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-3031
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Country | US
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Telephone | 954-570-4080
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Fax | 866-715-7529
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Provider Business Mailing Address
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Address Line | 12781 ORANGE GROVE BLVD
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-8912
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Country | US
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Telephone | 561-797-5132
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Fax | 866-715-7529
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. RYAN E SPICUZZO
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Credential | D.C.
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Telephone | 561-797-5132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | CH 10306
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License Number State | FL
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