Provider Demographics
NPI:1194060509
Name:WCK REHAB CENTER PLLC
Entity type:Organization
Organization Name:WCK REHAB CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HENRI
Authorized Official - Middle Name:CLAUDE
Authorized Official - Last Name:DOUZE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:754-200-6844
Mailing Address - Street 1:2314 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1422
Mailing Address - Country:US
Mailing Address - Phone:754-200-6844
Mailing Address - Fax:754-200-6845
Practice Address - Street 1:2314 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-1422
Practice Address - Country:US
Practice Address - Phone:754-200-6844
Practice Address - Fax:754-200-6845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4902251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherCHIROPRACTOR