Healthcare Provider Details

I. General information

NPI: 1053947556
Provider Name (Legal Business Name): WOODLANDS CHIROPRACTIC AND REHABILLITATION PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2020
Last Update Date: 03/16/2020
Certification Date: 03/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 TARPON WOODS BLVD STE F5
PALM HARBOR FL
34685-2000
US

IV. Provider business mailing address

800 TARPON WOODS BLVD STE F5
PALM HARBOR FL
34685-2000
US

V. Phone/Fax

Practice location:
  • Phone: 727-785-2771
  • Fax:
Mailing address:
  • Phone: 727-785-2771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRADFORD MYERS
Title or Position: OWNER/CHIROPRACTIC PHYSICIAN
Credential: D.C.
Phone: 727-785-2771