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General NPI Number Information
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NPI Number | 1770117582
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Entity Type | Organization
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Legal Business Name | DELRAY BEACH WELLNESS AND REHAB
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Dates
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Enumeration Date | 03/02/2020
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 5341 ATLANTIC AVE STE 305
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8166
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Country | US
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Telephone | 561-501-6477
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Fax | 561-501-6471
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Provider Business Mailing Address
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Address Line | 5341 ATLANTIC AVE STE 305
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8166
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Country | US
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Telephone | 561-501-6477
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Fax | 561-501-6471
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD CULLIGAN
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Credential | DC
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Telephone | 561-501-6477
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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 |
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License Number State |
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