MEDICARE: DR. STEVEN DENNIS INCLEDON DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	15204	FL

General Provider Information

NPI Number	:	1154149599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN DENNIS INCLEDON DC

Provider Business Mailing Address
First Line	:	6609 WOOLBRIGHT RD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-0910
Country	:	US
Telephone Number	:	561-865-8390
Fax Number	:	561-865-1730

Provider Business Practice Location Address
First Line	:	6609 WOOLBRIGHT RD STE 414
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-0910
Country	:	US
Telephone Number	:	561-865-8390
Fax Number	:	561-865-1730

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2024
Last Update Date	:	10/02/2024

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