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Organization
ACTIVE SPINE CHIROPRACTIC, P.A.
Active
Organization
ACTIVE SPINE CHIROPRACTIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY WITTGREEN D.C. (CEO / OWNER)
(786) 759-6265
Entity
Organization
Contact information
Practice address
1255 N FLAGLER DR, FORT LAUDERDALE, FL 33304-2131
(786) 759-6265
Mailing address
2421 NE 65TH ST, 307, FORT LAUDERDALE, FL 33308-1556
(786) 759-6265
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH10100
FL
Other
Enumeration date
09/03/2015
Last updated
09/03/2015
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