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General NPI Number Information
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NPI Number | 1629100540
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Entity Type | Organization
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Legal Business Name | J.R.P. DIAGNOSTICS & REHAB
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4384 N.W. 31 AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309
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Country | US
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Telephone | 954-486-1377
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Fax | 954-486-1374
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Provider Business Mailing Address
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Address Line | 4631 N.W. 31 AVE #135
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309
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Country | US
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Telephone | 954-486-1377
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Fax | 954-486-1374
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Authorized Official
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Title or Position | OWNER
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Name | GREGG POPKIN
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Credential | D.C.
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Telephone | 954-486-1377
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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 | DC 3832
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License Number State | FL
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