Provider Demographics
NPI:1548896327
Name:PALM BEACH CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:PALM BEACH CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FROBOSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-807-8908
Mailing Address - Street 1:249 PERUVIAN AVE # R2-2
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-6034
Mailing Address - Country:US
Mailing Address - Phone:570-807-8908
Mailing Address - Fax:
Practice Address - Street 1:249 PERUVIAN AVE # R2-2
Practice Address - Street 2:
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-6034
Practice Address - Country:US
Practice Address - Phone:570-807-8908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty