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General NPI Number Information
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NPI Number | 1932918448
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Entity Type | Organization
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Legal Business Name | JUPITER SPINE AND PERFORMANCE
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 600 HERITAGE DR STE 102
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City | JUPITER
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State | FL
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Zip | 33458-3098
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Country | US
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Telephone | 561-308-3588
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Fax |
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Provider Business Mailing Address
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Address Line | 5384 SAGAN LN
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-6233
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | ALYSSA GARBER
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Credential | DC
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Telephone | 561-308-3588
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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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