Poulos Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH9754 Issued in FL

Legal business name

POULOS CHIROPRACTIC, LLC

Practice address

727 Northlake Blvd Ste 4
North Palm Beach, FL 33408-5242

Phone

(561) 904-6066

NPI assigned

Feb 1, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wayne J Broth, DC

Title

DC

Phone

(561) 904-6066

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328054400000",
    "number": "1972875284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 NORTHLAKE BLVD STE 4",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334085242",
            "telephone_number": "561-904-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 NORTHLAKE BLVD STE 4",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334085242",
            "telephone_number": "561-904-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POULOS CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-01",
        "last_updated": "2012-02-01",
        "status": "A",
        "authorized_official_last_name": "BROTH",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DC",
        "authorized_official_telephone_number": "561-904-6066",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eduardo Prado I, D.D.S,M.S.D
• Professional Counseling and Consulting, Inc
• Prosperity Laboratory LLC
• Prosperity Palms, LLC
• Publix Super Markets Inc (Publix Pharmacy #0699)

• Chiropractor in North Palm Beach, FL
• Providers in North Palm Beach, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.