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General NPI Number Information
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NPI Number | 1710402896
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Entity Type | Organization
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Legal Business Name | DEMUTIIS CHIROPRACTIC LLC
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Dates
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Enumeration Date | 08/09/2017
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 5601 N FEDERAL HWY STE 2
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City | BOCA RATON
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State | FL
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Zip | 33487-4012
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Country | US
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Telephone | 561-419-6915
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Fax | 561-584-6566
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Provider Business Mailing Address
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Address Line | 5601 N FEDERAL HWY STE 2
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City | BOCA RATON
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State | FL
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Zip | 33487-4012
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Country | US
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Telephone | 561-419-6915
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Fax | 561-584-6566
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN J DEMUTIIS
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Credential | D.C.
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Telephone | 561-419-6915
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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 | CH11442
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License Number State | FL
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