MEDICARE: LIGHTHOUSE CHIROPRACTIC 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
1	111N00000X	Chiropractor	CH 9051	FL

General Provider Information

NPI Number	:	1811227465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIGHTHOUSE CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	3102 N FEDERAL HWY
Second Line	:
City	:	LIGHTHOUSE POINT
State	:	FL
Zip	:	33064-6738
Country	:	US
Telephone Number	:	954-933-3839
Fax Number	:	954-933-3836

Provider Business Practice Location Address
First Line	:	3102 N FEDERAL HWY
Second Line	:
City	:	LIGHTHOUSE POINT
State	:	FL
Zip	:	33064-6738
Country	:	US
Telephone Number	:	954-933-3839
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. DENNIS PHILLIP HARKINS
Credential	:	DC
Telephone Number	:	954-933-3839

Provider Enumeration Date	:	01/04/2010
Last Update Date	:	08/16/2012

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