MEDICARE: DR. DAVID ROBERT BUCHTHAL D.C.

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	CH 7668	FL

General Provider Information

NPI Number	:	1194999367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ROBERT BUCHTHAL D.C.

Provider Business Mailing Address
First Line	:	440 E SAMPLE RD STE 105
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-4432
Country	:	US
Telephone Number	:	954-786-0708
Fax Number	:	954-786-4735

Provider Business Practice Location Address
First Line	:	440 E SAMPLE RD STE 105
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-4432
Country	:	US
Telephone Number	:	954-786-0708
Fax Number	:	954-786-4735

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

Provider Enumeration Date	:	04/17/2008
Last Update Date	:	04/10/2009

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