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NPI Code Detail

MEDICARE: NORTH LAUDERDALE CHIROPRACTIC CENTER, INC.

MEDICARE: NORTH LAUDERDALE CHIROPRACTIC CENTER, INC.
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
1111N00000XChiropractor5008FL

General Provider Information

NPI Number : 1750408290
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH LAUDERDALE CHIROPRACTIC CENTER, INC.
Provider Business Mailing Address
First Line : 5460 N STATE ROAD 7
Second Line : SUITE 112
City : FORT LAUDERDALE
State : FL
Zip : 33319-2952
Country : US
Telephone Number : 954-735-3339
Fax Number : 954-735-3386
Provider Business Practice Location Address
First Line : 5460 N STATE ROAD 7
Second Line : SUITE 112
City : FORT LAUDERDALE
State : FL
Zip : 33319-2952
Country : US
Telephone Number : 954-735-3339
Fax Number : 954-735-3386
Authorized Official
Title or Position : PRESIDENT
Name : DR. DOUGLAS D. GAGNON
Credential : D.C.
Telephone Number : 954-735-3339
Provider Enumeration Date : 03/22/2007
Last Update Date : 08/22/2020

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Directions to “NORTH LAUDERDALE CHIROPRACTIC CENTER, INC. ” Practice Location

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