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General NPI Number Information
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NPI Number | 1619209780
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Entity Type | Organization
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Legal Business Name | TAO CHIROPRACTIC PA
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Dates
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Enumeration Date | 02/01/2010
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | 7730 PETERS RD
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City | PLANTATION
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State | FL
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Zip | 33324-4004
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Country | US
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Telephone | 561-573-6872
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Fax |
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Provider Business Mailing Address
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Address Line | 4779 TEMPLE DR
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City | DELRAY BEACH
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State | FL
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Zip | 33445-5321
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Country | US
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Telephone | 561-573-6872
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MIKE IACONO
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Credential |
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Telephone | 561-573-6872
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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 | CH 8384
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License Number State | FL
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