Healthcare Provider Details
I. General information
NPI: 1225543648
Provider Name (Legal Business Name): BIOMECHANICS WELLNESS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/07/2017
Last Update Date: 12/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2803 FRUITVILLE RD STE 130
SARASOTA FL
34237-5367
US
IV. Provider business mailing address
2803 FRUITVILLE RD STE 130
SARASOTA FL
34237-5367
US
V. Phone/Fax
- Phone: 941-281-5451
- Fax:
- Phone: 941-281-5451
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
TIM
BEKKERING
Title or Position: AMBR
Credential:
Phone: 941-323-3870