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General NPI Number Information
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NPI Number | 1477983435
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Entity Type | Organization
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Legal Business Name | MAXIMUM CHIROPRACTIC & WELLNESS CARE CENTER
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 11/12/2013
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Provider Practice Location Address
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Address Line | 625 SE 2ND AVE B
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-5065
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Country | US
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Telephone | 561-509-6020
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Fax |
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Provider Business Mailing Address
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Address Line | 625 SE 2ND AVE B
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-5065
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Country | US
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Telephone | 561-509-6020
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBINSON CHERESTAL
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Credential | DC
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Telephone | 561-509-6020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | CH10702
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License Number State | FL
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