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General NPI Number Information
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NPI Number | 1487942710
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Entity Type | Organization
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Legal Business Name | LONDON CHIROPRACTIC AND INJURY CENTER INC.
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Dates
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Enumeration Date | 07/20/2011
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Last Update Date | 07/20/2011
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Provider Practice Location Address
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Address Line | 7312 ROYAL PALM BLVD
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City | MARGATE
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State | FL
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Zip | 33063-6803
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Country | US
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Telephone | 954-977-8889
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Fax |
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Provider Business Mailing Address
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Address Line | 9851 N.W. 20 TH STREET
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-5839
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Country | US
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Telephone | 954-540-6224
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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. ROBERT GLEN LONDON
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Credential | D.C.
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Telephone | 954-977-8889
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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 | CH 8115
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License Number State | FL
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