Provider Demographics
NPI:1619790599
Name:MY BODYWORX CHIROPRACTIC
Entity type:Organization
Organization Name:MY BODYWORX CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-926-9494
Mailing Address - Street 1:14560 S MILITARY TRL STE B4
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-3794
Mailing Address - Country:US
Mailing Address - Phone:561-926-9494
Mailing Address - Fax:
Practice Address - Street 1:14560 S MILITARY TRL STE B4
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-3794
Practice Address - Country:US
Practice Address - Phone:561-926-9494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty