Provider Demographics
NPI:1548043995
Name:XLB PHYSICAL MEDICINE, LLC
Entity type:Organization
Organization Name:XLB PHYSICAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-323-3201
Mailing Address - Street 1:4760 WOOLBRIGHT RD STE 103
Mailing Address - Street 2:
Mailing Address - City:VILLAGE OF GOLF
Mailing Address - State:FL
Mailing Address - Zip Code:33436-6620
Mailing Address - Country:US
Mailing Address - Phone:561-323-3201
Mailing Address - Fax:561-431-0828
Practice Address - Street 1:4760 WOOLBRIGHT RD STE 103
Practice Address - Street 2:
Practice Address - City:VILLAGE OF GOLF
Practice Address - State:FL
Practice Address - Zip Code:33436-6620
Practice Address - Country:US
Practice Address - Phone:561-323-3201
Practice Address - Fax:561-431-0828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty