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General NPI Number Information
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NPI Number | 1710303458
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Entity Type | Organization
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Legal Business Name | GALT OCEAN CHIROPRACTIC INC
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Dates
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Enumeration Date | 03/05/2014
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Last Update Date | 03/05/2014
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Provider Practice Location Address
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Address Line | 3924 N OCEAN BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-6443
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Country | US
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Telephone | 954-218-0925
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Fax |
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Provider Business Mailing Address
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Address Line | 3924 N OCEAN BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-6443
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Country | US
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Telephone | 954-218-0925
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS ALLEN MENENDEZ
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Credential | DC
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Telephone | 954-218-0925
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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 10320
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License Number State | FL
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