Individual provider · Type 1 NPI
Victoria Widjaja, DC
Chiropractor · Lauderdale Lakes, FL
NPI number
1851757033
Active
Practice location
3500 N State Road 7 Ste 480
Lauderdale Lakes, FL 33319-5600
Mailing address
PO Box 770970
Coral Springs, FL 33077-0970
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | CH11707 (FL) |
| Chiropractor | 111N00000X | CH33319 (GA) |
Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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About NPI 1851757033
Victoria Widjaja, DC's National Provider Identifier is 1851757033, issued on Jan 4, 2016. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Lauderdale Lakes, FL. The record was last updated on Jan 22, 2016.