Provider Demographics
NPI:1205098308
Name:FRIEDMAN, JODI LYN (DC,)
Entity type:Individual
Prefix:DR
First Name:JODI
Middle Name:LYN
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:DC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 S POWERLINE RD STE 4
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-4332
Mailing Address - Country:US
Mailing Address - Phone:954-935-3101
Mailing Address - Fax:954-935-3102
Practice Address - Street 1:1280 S POWERLINE RD STE 4
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-4332
Practice Address - Country:US
Practice Address - Phone:954-935-3101
Practice Address - Fax:954-935-3102
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9609111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor