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Organization
VICTORY CHIROPRACTIC, INC.
Active
Organization
VICTORY CHIROPRACTIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VICTORIA WIDJAJA D.C. (ADMINISTRATOR)
(754) 215-6502
Entity
Organization
Contact information
Practice address
3500 N STATE ROAD 7, STE 480, LAUDERDALE LAKES, FL 33319-5600
(754) 215-6502
(954) 533-5242
Mailing address
3500 N STATE ROAD 7, STE 480, LAUDERDALE LAKES, FL 33319-5600
(754) 215-6502
(954) 533-5242
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH11707
FL
Other
Enumeration date
01/15/2016
Last updated
01/21/2016
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