Provider Demographics
NPI:1053530550
Name:CHAMBERLAIN, DARREN JACOB (DC)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:JACOB
Last Name:CHAMBERLAIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2916 NE 8TH TER
Mailing Address - Street 2:#104
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33334-6611
Mailing Address - Country:US
Mailing Address - Phone:561-254-9506
Mailing Address - Fax:
Practice Address - Street 1:2247 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1106
Practice Address - Country:US
Practice Address - Phone:954-428-2729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8892111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor