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General NPI Number Information
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NPI Number | 1932912722
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Entity Type | Organization
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Legal Business Name | THIRD SPACE CHIROPRACTIC
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 2200 BISCAYNE BLVD FL 2
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City | MIAMI
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State | FL
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Zip | 33137-5283
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Country | US
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Telephone | 630-457-6175
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Fax |
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Provider Business Mailing Address
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Address Line | 13800 EGRETS NEST DR APT 1923
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City | JACKSONVILLE
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State | FL
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Zip | 32258-4250
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Country | US
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Telephone | 630-457-6175
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LIRON SALETSKY
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Credential | DC
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Telephone | 630-457-6175
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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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