=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386226959
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORDIK CHIROPRACTIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/23/2021
-----------------------------------------------------
Last Update Date | 04/23/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4601 MILITARY TRL STE 209
-----------------------------------------------------
City | JUPITER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33458-4837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-781-8210
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4601 MILITARY TRL STE 209
-----------------------------------------------------
City | JUPITER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33458-4837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-781-8210
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CHELSEY R STEINARSSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 561-254-3630
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------