Healthcare Provider Details

I. General information

NPI: 1205341930
Provider Name (Legal Business Name): TUTTLE HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 01/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2595 TAMPA RD STE H
PALM HARBOR FL
34684-3130
US

IV. Provider business mailing address

2595 TAMPA RD STE H
PALM HARBOR FL
34684-3130
US

V. Phone/Fax

Practice location:
  • Phone: 678-334-1504
  • Fax:
Mailing address:
  • Phone: 727-509-3760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number12257
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number14564
License Number StateFL

VIII. Authorized Official

Name: DR. DANIEL MARK TUTTLE
Title or Position: CHIROPRACTIC PHYSICIAN
Credential: DC
Phone: 678-334-1504