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General NPI Number Information
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NPI Number | 1992472351
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Entity Type | Organization
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Legal Business Name | LC CHIROPRACTIC LLC
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Dates
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Enumeration Date | 08/24/2021
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 12145 SHERIDAN ST.
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City | COOPER CITY
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State | FL
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Zip | 33026
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Country | US
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Telephone | 754-233-0260
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Fax |
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Provider Business Mailing Address
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Address Line | 1128 SW 146TH TER
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-6165
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Country | US
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Telephone | 815-735-7445
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | JULIAN LAZARO MACHADO
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Credential | DC
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Telephone | 753-233-0260
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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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