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General NPI Number Information
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NPI Number | 1942251970
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Entity Type | Organization
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Legal Business Name | WEISS FAMILY CHIROPRACTIC CTR
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 04/20/2012
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Provider Practice Location Address
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Address Line | 11924 W FOREST HILL BLVD STE 13
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City | WELLINGTON
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State | FL
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Zip | 33414
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Country | US
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Telephone | 561-753-6077
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Fax | 561-753-6095
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Provider Business Mailing Address
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Address Line | 11924 W FOREST HILL BLVD STE 13
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City | WELLINGTON
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State | FL
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Zip | 33414
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Country | US
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Telephone | 561-753-6077
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Fax | 561-753-6095
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Authorized Official
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Title or Position | OWNER
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Name | DR. CETTY M WEISS
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Credential | DC
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Telephone | 561-753-6077
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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 | 5180
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5181
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License Number State | FL
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