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NPI Code Detail

MEDICARE: CHANG CHIROPRACTIC INC

MEDICARE: CHANG 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
1261Q00000XClinic/CenterCH8405FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
164015OTHERFLBLUE CROSS BLUE SHIELD FL

General Provider Information

NPI Number : 1821038639
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHANG CHIROPRACTIC INC
Provider Business Mailing Address
First Line : 1803 NE JENSEN BEACH BLVD
Second Line :
City : JENSEN BEACH
State : FL
Zip : 34957-7233
Country : US
Telephone Number : 772-334-1377
Fax Number :
Provider Business Practice Location Address
First Line : 1803 NE JENSEN BEACH BLVD
Second Line :
City : JENSEN BEACH
State : FL
Zip : 34957-7233
Country : US
Telephone Number : 772-334-1377
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. JOEY BRIAN CHANG
Credential : D.C.
Telephone Number : 772-337-1377
Provider Enumeration Date : 06/08/2006
Last Update Date : 11/12/2008

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Directions to “CHANG CHIROPRACTIC INC ” Practice Location

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