Provider Demographics
NPI:1306623434
Name:SOMA CHIROPRACTIC INC.
Entity type:Organization
Organization Name:SOMA CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CID MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CORREA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-728-6060
Mailing Address - Street 1:85 SE 4TH AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4574
Mailing Address - Country:US
Mailing Address - Phone:561-728-6060
Mailing Address - Fax:
Practice Address - Street 1:85 SE 4TH AVE STE 109
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-4574
Practice Address - Country:US
Practice Address - Phone:561-728-6060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty