| Dynamic Chiropractic, Inc. | |
|
1730 E Commercial Boulevard Fort Lauderdale FL 33334 | |
| (954) 938-4321 | |
| (954) 938-4322 |
| Full Name | Dynamic Chiropractic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1730 E Commercial Boulevard, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Kimberly Ann O'gorman (OWNER) |
| Authorized Official Contact | 9549384321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Chiropractic, Inc. 1730 E Commercial Boulevard Fort Lauderdale FL 33334 Ph: (954) 938-4321 | Dynamic Chiropractic, Inc. 1730 E Commercial Boulevard Fort Lauderdale FL 33334 Ph: (954) 938-4321 |
| NPI Number | 1306037155 |
|---|---|
| Provider Enumeration Date | 08/07/2007 |
| Last Update Date | 12/08/2011 |
| Medicare PECOS PAC ID | 4789765769 |
|---|---|
| Medicare Enrollment ID | O20080116000107 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306037155 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | CH 8533 (Florida) | Secondary |
| 261Q00000X | Clinic/center | CH8533 (Florida) | Primary |
| Provider Name | Kimberly A O Gorman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1023102605 PECOS PAC ID: 5597859538 Enrollment ID: I20070920000697 |
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