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General NPI Number Information
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NPI Number | 1851661037
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Entity Type | Organization
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Legal Business Name | GALT CHIROPRACTIC OFFICE, INC.
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Dates
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Enumeration Date | 01/05/2012
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 3305 NE 33RD ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-7109
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Country | US
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Telephone | 954-565-8122
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Fax | 954-565-4304
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Provider Business Mailing Address
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Address Line | 3305 NE 33RD ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-7109
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Country | US
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Telephone | 954-565-8122
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Fax | 954-565-4304
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. KEVIN MICHAEL MCNAMARA
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Credential | D.C.
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Telephone | 954-565-8122
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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 | CH3033
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License Number State | FL
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