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General NPI Number Information
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NPI Number | 1346531480
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Entity Type | Organization
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Legal Business Name | PERRY CHIROPRACTIC CENTER, INC.
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Dates
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Enumeration Date | 04/25/2011
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Last Update Date | 01/04/2014
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Provider Practice Location Address
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Address Line | 90 TILFORD E SUITE T
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-2106
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Country | US
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Telephone | 828-773-9018
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Fax |
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Provider Business Mailing Address
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Address Line | 160 W CAMINO REAL 240
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City | BOCA RATON
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State | FL
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Zip | 33432-5942
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Country | US
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Telephone | 828-773-9018
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Fax |
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Authorized Official
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Title or Position | VP
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Name | EDITH E PERRY
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Credential | D.C.
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Telephone | 828-773-9018
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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 | CH6711
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License Number State | FL
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