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General NPI Number Information
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NPI Number | 1932263233
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Entity Type | Organization
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Legal Business Name | ARTIBONITE INJURY CARE CENTER
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7358 LAKE WORTH RD
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City | LAKE WORTH
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State | FL
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Zip | 33467-2529
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Country | US
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Telephone | 561-966-6158
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Fax | 561-966-6159
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Provider Business Mailing Address
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Address Line | 7358 LAKE WORTH RD
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City | LAKE WORTH
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State | FL
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Zip | 33467-2529
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Country | US
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Telephone | 561-966-6158
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Fax | 561-966-6159
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MORILUS DAT
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Credential |
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Telephone | 561-966-6158
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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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