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General NPI Number Information
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NPI Number | 1548043995
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Entity Type | Organization
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Legal Business Name | XLB PHYSICAL MEDICINE, LLC
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Dates
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Enumeration Date | 08/17/2023
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 4760 WOOLBRIGHT RD STE 103
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City | VILLAGE OF GOLF
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State | FL
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Zip | 33436-6620
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Country | US
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Telephone | 561-323-3201
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Fax | 561-431-0828
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Provider Business Mailing Address
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Address Line | 4760 WOOLBRIGHT RD STE 103
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City | VILLAGE OF GOLF
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State | FL
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Zip | 33436-6620
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Country | US
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Telephone | 561-323-3201
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Fax | 561-431-0828
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW BOSIER
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Credential | DC
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Telephone | 561-323-3201
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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 |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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