Provider Demographics
NPI:1811139314
Name:PALM SPRINGS CHIROPRACTIC AND WELLNESS CENTER, PA
Entity type:Organization
Organization Name:PALM SPRINGS CHIROPRACTIC AND WELLNESS CENTER, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-642-9901
Mailing Address - Street 1:2326 S CONGRESS AVE
Mailing Address - Street 2:2-C
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7617
Mailing Address - Country:US
Mailing Address - Phone:561-642-9901
Mailing Address - Fax:
Practice Address - Street 1:2326 S CONGRESS AVE
Practice Address - Street 2:2-C
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33406
Practice Address - Country:US
Practice Address - Phone:561-642-9901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8284261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1669683231OtherNPI
FL1669683231OtherNPI