Provider Demographics
NPI:1932911682
Name:SELFCARE CHIROPRACTIC WELLNESS & INJURY LLC
Entity type:Organization
Organization Name:SELFCARE CHIROPRACTIC WELLNESS & INJURY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ERICSON
Authorized Official - Middle Name:
Authorized Official - Last Name:VIBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-249-1860
Mailing Address - Street 1:6079 LAKE WORTH RD
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-4288
Mailing Address - Country:US
Mailing Address - Phone:561-249-1860
Mailing Address - Fax:561-249-0425
Practice Address - Street 1:6079 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-4288
Practice Address - Country:US
Practice Address - Phone:561-249-1860
Practice Address - Fax:561-249-0425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty