Provider Demographics
NPI:1194073296
Name:PLANTATION SPINAL CARE CENTER, INC.
Entity type:Organization
Organization Name:PLANTATION SPINAL CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:LESHAW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-452-0010
Mailing Address - Street 1:10063 CLEARY BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1063
Mailing Address - Country:US
Mailing Address - Phone:954-452-0010
Mailing Address - Fax:954-452-0065
Practice Address - Street 1:10063 CLEARY BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1063
Practice Address - Country:US
Practice Address - Phone:954-452-0010
Practice Address - Fax:954-452-0065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty