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General NPI Number Information
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NPI Number | 1588935449
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Entity Type | Organization
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Legal Business Name | SUNRISE CHIROPRACTIC WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 12651 W SUNRISE BLVD SUITE 204
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City | SUNRISE
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State | FL
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Zip | 33323-0906
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Country | US
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Telephone | 954-846-8244
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Fax | 954-846-9244
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Provider Business Mailing Address
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Address Line | 12651 W SUNRISE BLVD SUITE 204
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City | SUNRISE
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State | FL
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Zip | 33323-0906
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Country | US
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Telephone | 954-846-8244
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Fax | 954-846-9244
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. CHARLES D HELFELD
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Credential | DC
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Telephone | 954-846-8244
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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 | CH6332
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License Number State | FL
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