Provider Demographics
NPI:1194953174
Name:BUILT BY DESIGN CHIROPRACTIC
Entity type:Organization
Organization Name:BUILT BY DESIGN CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYSEN
Authorized Official - Middle Name:TORREY
Authorized Official - Last Name:SUDNYKOVYCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-629-3501
Mailing Address - Street 1:8409 N MILITARY TRL STE 113
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6321
Mailing Address - Country:US
Mailing Address - Phone:561-253-0844
Mailing Address - Fax:
Practice Address - Street 1:8409 N MILITARY TRL STE 113
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-6321
Practice Address - Country:US
Practice Address - Phone:561-253-0844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9217111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty