Provider Demographics
NPI:1194999367
Name:BUCHTHAL, DAVID ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROBERT
Last Name:BUCHTHAL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 E SAMPLE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-4432
Mailing Address - Country:US
Mailing Address - Phone:954-786-0708
Mailing Address - Fax:954-786-4735
Practice Address - Street 1:440 E SAMPLE RD STE 105
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-4432
Practice Address - Country:US
Practice Address - Phone:954-786-0708
Practice Address - Fax:954-786-4735
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7668111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor