Healthcare Provider Details

I. General information

NPI: 1467294355
Provider Name (Legal Business Name): ACHIEVEABILITY THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2024
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18288 N US HIGHWAY 41
LUTZ FL
33549-4400
US

IV. Provider business mailing address

18288 N US HIGHWAY 41
LUTZ FL
33549-4400
US

V. Phone/Fax

Practice location:
  • Phone: 813-527-9638
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY FAYE HULL
Title or Position: OWNER
Credential:
Phone: 813-527-9638