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General NPI Number Information
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NPI Number | 1417142688
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Entity Type | Organization
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Legal Business Name | FAMILY WELLNESS CENTERS INC
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 4723 W ATLANTIC AVE SUITE A-13
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City | DELRAY BEACH
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State | FL
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Zip | 33445-3895
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Country | US
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Telephone | 561-498-1098
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Fax | 561-495-2524
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Provider Business Mailing Address
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Address Line | 4723 W ATLANTIC AVE SUITE A-13
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City | DELRAY BEACH
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State | FL
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Zip | 33445-3895
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Country | US
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Telephone | 561-498-1098
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Fax | 561-495-2524
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. DAVID LIVINGSTON
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Credential | D.C.
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Telephone | 561-498-1098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | OS7123
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH7126
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License Number State | FL
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