Victoria R Widjaja
VICTORY CHIROPRACTIC, INC.


Address: 3500 N State Rd, Lauderdale Lakes, FL 33319-5600
Phone: 7542156502

Victoria R Widjaja (NPI# 1851757033, PAC ID# 4082909593) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CHIROPRACTIC.

Physician Overview

Nation Provider ID (NPI) 1851757033
PAC ID by PECOS 4082909593
Professional Enrollment ID I20160823002389
Full Name Victoria R Widjaja
Organization Legal Name VICTORY CHIROPRACTIC, INC.
Address 3500 N State Rd
Lauderdale Lakes
FL 33319-5600
Phone Number 7542156502
Gender F
Graduation Year 2013
Primary Specialty CHIROPRACTIC
Secondary Specialties PHYSICAL MEDICINE AND REHABILITATION
Group Practice PAC ID 0749575256
Accepts Medicare Assignment Y

Other Locations

Address Phone Organization
3500 N State Rd, Lauderdale Lakes, FL 33319-5600 7542156502 VICTORY CHIROPRACTIC, INC.
3500 N State Rd, 7 Suite 480, Lauderdale Lakes, FL 33319-5600 7542156502 VICTORY CHIROPRACTIC, INC.

Organization Information

Organization Legal Name VICTORY CHIROPRACTIC, INC.
Physicians 1

Office Location

Street Address 3500 N STATE RD
City LAUDERDALE LAKES
State FL
Zip 33319-5600

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Competitor

Search similar physicians

City LAUDERDALE LAKES
Zip Code 33319
Specialty CHIROPRACTIC
City + Specialty LAUDERDALE LAKES + CHIROPRACTIC

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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