| Organization Name: | INJURY TREATMENT CENTER OF BOYNTON BEACH INC |
| NPI Number: | 1760503015 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EVAN SADE (CONSULTANT) |
| Mailing Address: | 1325 S Congress Ave Boynton Beach |
| State: | FL US |
| Postal Code: | 334265876 |
| Phone Number: | 5617368060 |
| Fax Number: | 5617360548 |
| NPI Enumeration Date: | 04/03/2007 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | HCC3660 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |