Provider Demographics
NPI:1932912722
Name:THIRD SPACE CHIROPRACTIC
Entity type:Organization
Organization Name:THIRD SPACE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LIRON
Authorized Official - Middle Name:
Authorized Official - Last Name:SALETSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-457-6175
Mailing Address - Street 1:13800 EGRETS NEST DR APT 1923
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-4250
Mailing Address - Country:US
Mailing Address - Phone:630-457-6175
Mailing Address - Fax:
Practice Address - Street 1:2200 BISCAYNE BLVD FL 2
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-5283
Practice Address - Country:US
Practice Address - Phone:630-457-6175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty