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General NPI Number Information
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NPI Number | 1295778975
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Entity Type | Organization
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Legal Business Name | CONGRESSCHIROPRACTIC CENTER
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2326 S. CONGRESS AVENUE SUITE 2-C
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City | PALM SPRINGS
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State | FL
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Zip | 33406
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Country | US
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Telephone | 561-433-8999
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Fax | 561-828-0431
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Provider Business Mailing Address
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Address Line | 2326 S. CONGRESS AVENUE SUITE 2-C
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City | PALM SPRINGS
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State | FL
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Zip | 33406
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Country | US
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Telephone | 561-433-8999
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Fax | 561-828-0431
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TIM HANSEN
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Credential | D.C.
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Telephone | 561-433-8999
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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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