Healthcare Provider Details

I. General information

NPI: 1427595057
Provider Name (Legal Business Name): INN8 INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2017
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 N BABCOCK ST
MELBOURNE FL
32935-6717
US

IV. Provider business mailing address

220 N BABCOCK ST
MELBOURNE FL
32935-6717
US

V. Phone/Fax

Practice location:
  • Phone: 321-327-7014
  • Fax: 321-473-7383
Mailing address:
  • Phone: 321-327-7014
  • Fax: 321-821-1924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: LARRY LEE SMITH
Title or Position: PHYSICIAN OWNER
Credential: DC
Phone: 321-327-7014