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General NPI Number Information
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NPI Number | 1962735597
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Entity Type | Organization
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Legal Business Name | SOUTH BROWARD CHIROPRACTIC CENTER INC
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Dates
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Enumeration Date | 09/15/2009
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Last Update Date | 07/02/2012
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Provider Practice Location Address
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Address Line | 427 E SHERIDAN ST
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City | DANIA BEACH
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State | FL
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Zip | 33004-4603
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Country | US
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Telephone | 954-929-1888
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Fax | 954-929-1770
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Provider Business Mailing Address
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Address Line | 427 E SHERIDAN ST
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City | DANIA BEACH
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State | FL
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Zip | 33004-4603
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Country | US
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Telephone | 954-929-1888
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Fax | 954-929-1770
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEITH MARTIN BUCHALTER
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Credential | D.C.
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Telephone | 954-929-1888
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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 | CHOOO5970
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License Number State | FL
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