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General NPI Number Information
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NPI Number | 1528469103
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Entity Type | Organization
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Legal Business Name | LINCOLN PARK REHAB
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 8910 MIRAMAR PKWY SUITE 308
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City | MIRAMAR
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State | FL
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Zip | 33025-4100
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Country | US
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Telephone | 954-889-3422
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Fax | 407-926-0844
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Provider Business Mailing Address
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Address Line | PO BOX 770056
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City | CORAL SPRINGS
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State | FL
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Zip | 33077-0056
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Country | US
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Telephone | 954-415-2405
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Fax | 407-926-0844
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. CATHERINE ANNE WALTON
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Credential | DC
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Telephone | 954-415-2405
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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 |
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License Number State | FL
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