MEDICARE: KATHY JO PANSEGRAU DC 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	CH8430	FL

General Provider Information

NPI Number	:	1952453227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATHY JO PANSEGRAU DC INC

Provider Business Mailing Address
First Line	:	750 E SAMPLE RD
Second Line	:	BUILDING 3 SUITE 1
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-5144
Country	:	US
Telephone Number	:	954-782-8200
Fax Number	:	954-782-8909

Provider Business Practice Location Address
First Line	:	750 E SAMPLE RD
Second Line	:	BUILDING 3 SUITE 1
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-5144
Country	:	US
Telephone Number	:	954-782-8200
Fax Number	:	954-782-8909

Authorized Official
Title or Position	:	CHIROPRACTIC PHYSICIAN
Name	:	DR. KATHY JO PANSEGRAU
Credential	:	D.C.
Telephone Number	:	954-782-8200

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	08/22/2020

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