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General NPI Number Information
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NPI Number | 1477675999
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Entity Type | Organization
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Legal Business Name | NORTHWEST CENTER FOR INTEGRATIVE MEDICINE AND REHABILITATION
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 2960 N STATE ROAD 7 SUITE 204
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City | MARGATE
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State | FL
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Zip | 33063-5755
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Country | US
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Telephone | 954-977-9077
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Fax | 954-979-0675
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Provider Business Mailing Address
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Address Line | 2960 N STATE ROAD 7 SUITE 204
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City | MARGATE
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State | FL
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Zip | 33063-5755
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Country | US
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Telephone | 954-977-9077
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Fax | 954-979-0675
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Authorized Official
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Title or Position | DIRECTOR OF CLINIC
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Name | DR. ABRAHAM ROBERT FREEMAN
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Credential | D.C.
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Telephone | 954-977-9077
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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 | CH0004917
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | CH0006667
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP1704
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP1605
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | ME27172
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License Number State | FL
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