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General NPI Number Information
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NPI Number | 1801251871
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Entity Type | Organization
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Legal Business Name | A PLACE OF HEALTH CHIROPRACTIC
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Dates
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Enumeration Date | 12/17/2015
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Last Update Date | 12/17/2015
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Provider Practice Location Address
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Address Line | 2034 E OAKLAND PARK BLVD
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City | FT LAUDERDALE
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State | FL
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Zip | 33306-1107
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Country | US
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Telephone | 954-568-9355
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Fax | 954-568-6079
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Provider Business Mailing Address
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Address Line | 1007 N FEDERAL HWY SUITE 232
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City | FT LAUDERDALE
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State | FL
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Zip | 33304-1422
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Country | US
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Telephone | 954-568-9355
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DONNA LYNN WATSON
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Credential | CHIROPRACTOR
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Telephone | 954-568-9355
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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 | CH7063
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License Number State | FL
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