Organization · NPI-2

3rd-Leg Of The Stool

Chiropractor, Nutrition · Boca Raton, FL

NPI number1407276777
StatusActive
Last updated in NPPESApr 24, 2014

Details

NPI
1407276777
Entity type
Organization (NPI-2)
Legal business name
3rd-Leg Of The Stool
Organization subpart
No
Enumeration date
Apr 24, 2014
Last updated
Apr 24, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111NN1001X Chiropractor, NutritionCH5524FLYes

Practice location

800 Jeffery St Apt 407
Boca Raton, FL 33487-4166

Phone 954-341-6446

Mailing address

800 Jeffery St Apt 407
Boca Raton, FL 33487-4166

Phone 954-341-6446

Authorized official

Mark A Shader
Pres
9543416446

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