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General NPI Number Information
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NPI Number | 1376459370
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Entity Type | Organization
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Legal Business Name | RESTORE CHIROPRACTIC CENTER LLC
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Dates
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Enumeration Date | 08/20/2026
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Last Update Date | 08/20/2026
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Provider Practice Location Address
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Address Line | 600 SANDTREE DR STE 202C
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33403-1538
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Country | US
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Telephone | 561-203-9650
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Fax |
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Provider Business Mailing Address
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Address Line | 932 SANCTUARY COVE DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33410-4517
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Country | US
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Telephone | 561-203-9650
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER/MANAGER/OWNER
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Name | DR. CHRISTOPHER CUCULLU
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Credential | DC
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Telephone | 907-244-3541
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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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