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LAKE WORTH PHYSICAL MEDICINE NPI 1043579618


NPI Information

NPI: 1043579618
Provider Name: LAKE WORTH PHYSICAL MEDICINE

Doing Business As: PALM BEACH PHYSICAL MEDICINE

Classification: Chiropractor - 111N00000X
Entity Type: Organization

CLIA Number: 10D1057726

Address:
1722-A SOUTH CONGRESS AVE
PALM SPRINGS, FL
ZIP 33461
Phone: (561) 868-5668
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LAKE WORTH PHYSICAL MEDICINE is a chiropractor in Palm Springs, FL. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. LAKE WORTH PHYSICAL MEDICINE NPI is 1043579618. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Palm Beach Physical Medicine.

The provider's business location address is:

1722-A SOUTH CONGRESS AVE
PALM SPRINGS, FL
ZIP 33461
Phone: (561) 868-5668
Fax: (561) 868-5702

The provider's authorized official is Jonathan Grand .
The authorized official title is President and has the following contact phone number (561) 729-7089.

The CLIA number assigned to this NPI record is 10D1057726 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/16/2012 and was last updated on 11/2/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractorCH9392FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.