Organization
FOUNTAINS THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA KAY HUSEBOE D.C. (OWNER)
(954) 424-9724
Entity
Organization
Contact information
Practice address
817 S UNIVERSITY DR, SUITE 105, PLANTATION, FL 33324-3309
(954) 424-9724
(954) 424-9533
Mailing address
817 S UNIVERSITY DR, SUITE 105, PLANTATION, FL 33324-3309
(954) 424-9724
(954) 424-9533
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH6941
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55423
PRV#BS
FL
Enumeration date
02/22/2007
Last updated
08/22/2020
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