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General NPI Number Information
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NPI Number | 1528238052
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Entity Type | Organization
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Legal Business Name | DANIA BEACH CHIROPRACTIC CENTER, PA
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 06/01/2015
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Provider Practice Location Address
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Address Line | 394 E DANIA BEACH BLVD
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City | DANIA BEACH
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State | FL
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Zip | 33004-3051
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Country | US
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Telephone | 954-925-7011
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Fax | 954-925-9961
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Provider Business Mailing Address
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Address Line | 394 E DANIA BEACH BLVD
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City | DANIA BEACH
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State | FL
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Zip | 33004-3051
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Country | US
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Telephone | 954-925-7011
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Fax | 954-925-9961
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JONATHAN MARC HIRSCH
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Credential | DC
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Telephone | 954-925-7011
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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 | CH 7073
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License Number State | FL
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