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General NPI Number Information
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NPI Number | 1982771689
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Entity Type | Organization
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Legal Business Name | CITADEL CHIROPRACTIC, PA
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 660 W BOYNTON BEACH BLVD
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-3637
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Country | US
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Telephone | 561-752-5354
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Fax | 561-752-5868
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Provider Business Mailing Address
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Address Line | 660 W BOYNTON BEACH BLVD
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-3637
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Country | US
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Telephone | 561-752-5354
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Fax | 561-752-5868
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Authorized Official
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Title or Position | PRESIDENT
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Name | WEDLER A ALEXANDRE
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Credential | D.C.
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Telephone | 561-752-5354
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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 | CH7816
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License Number State | FL
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