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General NPI Number Information
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NPI Number | 1932911682
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Entity Type | Organization
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Legal Business Name | SELFCARE CHIROPRACTIC WELLNESS & INJURY LLC
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 6079 LAKE WORTH RD
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City | GREENACRES
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State | FL
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Zip | 33463-4288
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Country | US
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Telephone | 561-249-1860
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Fax | 561-249-0425
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Provider Business Mailing Address
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Address Line | 6079 LAKE WORTH RD
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City | GREENACRES
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State | FL
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Zip | 33463-4288
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Country | US
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Telephone | 561-249-1860
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Fax | 561-249-0425
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | ERICSON VIBERT
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Credential |
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Telephone | 561-249-1860
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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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