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General NPI Number Information
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NPI Number | 1326512849
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Entity Type | Organization
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Legal Business Name | PALM SPRINGS SPINAL CARE, INC
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 01/17/2019
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Provider Practice Location Address
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Address Line | 3003 S CONGRESS AVE STE 1D
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City | PALM SPRINGS
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State | FL
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Zip | 33461-2169
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Country | US
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Telephone | 561-619-3902
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Fax | 561-619-3902
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Provider Business Mailing Address
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Address Line | 3003 S CONGRESS AVE STE 1D
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City | PALM SPRINGS
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State | FL
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Zip | 33461-2169
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Country | US
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Telephone | 561-619-3902
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Fax | 561-619-3902
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Authorized Official
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Title or Position | OWNER
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Name | WESNER MENTOR
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Credential | DC
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Telephone | 561-267-6960
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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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