Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CH 7942 | FL |
NPI | 1346372596 |
---|---|
Provider Name | Olga Spivak |
First Address | Hollywood, FL 33019-5010 |
Second Address | Hallandale Beach, FL 33009-4726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 08/07/2013 |