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General NPI Number Information
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NPI Number | 1417444613
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Entity Type | Organization
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Legal Business Name | OAKLAND PARK SPINAL CARE, INC
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Dates
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Enumeration Date | 04/13/2018
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Last Update Date | 04/13/2018
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Provider Practice Location Address
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Address Line | 2700 W OAKLAND PARK BLVD STE 23
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City | OAKLAND PARK
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State | FL
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Zip | 33311-1311
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Country | US
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Telephone | 954-990-5933
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Fax | 954-990-5961
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Provider Business Mailing Address
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Address Line | 1722 17TH LN
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City | GREENACRES
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State | FL
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Zip | 33463-4361
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Country | US
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Telephone | 561-267-6960
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Fax |
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Authorized Official
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Title or Position | ONWER
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Name | DR. WESNER MENTOR
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Credential | DC
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Telephone | 954-990-5933
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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 | CH11422
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License Number State | FL
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