Provider Demographics
NPI:1104242411
Name:AUTHENTIC HEALTH SOLUTIONS
Entity type:Organization
Organization Name:AUTHENTIC HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:LUKE
Authorized Official - Last Name:BOSIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-862-9762
Mailing Address - Street 1:110 SE 4TH AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4569
Mailing Address - Country:US
Mailing Address - Phone:561-862-9762
Mailing Address - Fax:561-808-7399
Practice Address - Street 1:110 SE 4TH AVE STE 105
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-4569
Practice Address - Country:US
Practice Address - Phone:561-862-9762
Practice Address - Fax:561-808-7399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10165111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty