MEDICARE: HOLLYWOOD ACCIDENT & INJURY CENTER LLC

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	CH6000	FL

General Provider Information

NPI Number	:	1669770236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLLYWOOD ACCIDENT & INJURY CENTER LLC

Provider Business Mailing Address
First Line	:	4401 SHERIDAN ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3513
Country	:	US
Telephone Number	:	954-589-0730
Fax Number	:	954-589-0733

Provider Business Practice Location Address
First Line	:	4401 SHERIDAN ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3513
Country	:	US
Telephone Number	:	954-589-0730
Fax Number	:	954-589-0733

Authorized Official
Title or Position	:	PHYS
Name	:	DR. JEFFREY MARC FEILER
Credential	:	DC
Telephone Number	:	954-589-0730

Provider Enumeration Date	:	03/07/2011
Last Update Date	:	03/07/2011

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