Provider Demographics
NPI:1215053681
Name:PALM CHIROPRACTIC CENTER, INC.
Entity type:Organization
Organization Name:PALM CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPA-WOOLHISER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-438-3010
Mailing Address - Street 1:611 NW 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6160
Mailing Address - Country:US
Mailing Address - Phone:954-438-3010
Mailing Address - Fax:954-438-4679
Practice Address - Street 1:611 NW 99TH AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6160
Practice Address - Country:US
Practice Address - Phone:954-438-3010
Practice Address - Fax:954-438-4679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH006582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty