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General NPI Number Information
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NPI Number | 1407148034
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Entity Type | Organization
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Legal Business Name | 3 LAKES CHIROPRACTIC CENTER INC
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Dates
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Enumeration Date | 05/16/2011
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Last Update Date | 05/16/2011
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Provider Practice Location Address
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Address Line | 3601 W COMMERCIAL BLVD SUITE #11
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-3300
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Country | US
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Telephone | 954-739-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 3601 W COMMERCIAL BLVD SUITE #11
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-3300
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Country | US
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Telephone | 954-739-3000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARTI SINNREICH
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Credential | D.C.
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Telephone | 954-739-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | CH0005170
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License Number State | FL
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