Provider Demographics
NPI:1851155899
Name:DYNAMIX CHIROPRACTIC LLC
Entity type:Organization
Organization Name:DYNAMIX CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:SANANDAJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:772-233-8483
Mailing Address - Street 1:969 SE FEDERAL HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3716
Mailing Address - Country:US
Mailing Address - Phone:772-233-8483
Mailing Address - Fax:
Practice Address - Street 1:969 SE FEDERAL HWY STE 300
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3716
Practice Address - Country:US
Practice Address - Phone:772-233-8483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-09
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty