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NPI Code Detail

MEDICARE: GLEN BOBKER DC PA

MEDICARE: GLEN BOBKER DC PA
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
1111N00000XChiropractorCH6552FL

General Provider Information

NPI Number : 1285657643
Entity Type Code : Organization
Provider Name (Legal Business Name) : GLEN BOBKER DC PA
Provider Business Mailing Address
First Line : 1601 EAST BROWARD BLVD
Second Line : SUITE B
City : FORT LAUDERDALE
State : FL
Zip : 33301-2160
Country : US
Telephone Number : 954-463-1166
Fax Number : 954-522-6836
Provider Business Practice Location Address
First Line : 1601 EAST BROWARD BLVD
Second Line : SUITE B
City : FORT LAUDERDALE
State : FL
Zip : 33301-2160
Country : US
Telephone Number : 954-463-1166
Fax Number : 954-522-6836
Authorized Official
Title or Position : PRESIDENT
Name : GLEN BOBKER
Credential : DC
Telephone Number : 954-463-1166
Provider Enumeration Date : 07/26/2006
Last Update Date : 08/22/2020

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Directions to “GLEN BOBKER DC PA ” Practice Location

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