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General NPI Number Information
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NPI Number | 1528239092
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Entity Type | Organization
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Legal Business Name | BENJAMIN CHIROPRACTIC INC.
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 100 E SAMPLE RD STE 130
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City | POMPANO BEACH
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State | FL
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Zip | 33064-3554
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Country | US
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Telephone | 954-788-8882
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Fax | 954-582-9855
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Provider Business Mailing Address
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Address Line | 100 E SAMPLE RD STE 130
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City | POMPANO BEACH
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State | FL
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Zip | 33064-3554
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Country | US
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Telephone | 954-788-8882
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Fax | 954-582-9855
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Authorized Official
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Title or Position | OWNER
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Name | RODRIGUE BENJAMIN
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Credential | DC
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Telephone | 954-788-8882
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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 | CH8674
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License Number State | FL
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