Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 28324 | FL |
NPI | 1336741081 |
---|---|
Provider Name | Sheldon Stanley |
First Address | Deerfield Beach, FL 33064-4441 |
Second Address | Deerfield Beach, FL 33064-4441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2020 |
Last Update Date | 09/11/2020 |