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General NPI Number Information
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NPI Number | 1689852915
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Entity Type | Organization
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Legal Business Name | ABACOA TOWN CENTER CHIROPRACTIC INC
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 03/15/2011
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Provider Practice Location Address
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Address Line | 3003 S CONGRESS AVE SUITE 2F
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City | PALM SPRINGS
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State | FL
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Zip | 33461-2169
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Country | US
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Telephone | 561-963-6227
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Fax | 561-963-4199
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Provider Business Mailing Address
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Address Line | 600 UNIVERSITY BLVD STE 105
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City | JUPITER
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State | FL
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Zip | 33458-2778
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Country | US
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Telephone | 561-622-6111
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Fax | 561-622-1176
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSHUA SMITH
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Credential | DC
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Telephone | 561-622-6111
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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 | CH7246
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License Number State | FL
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