Healthcare Provider Details

I. General information

NPI: 1952825473
Provider Name (Legal Business Name): DC HEALTH SUCCESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10543 CHALMER ST
SPRING HILL FL
34609-2411
US

IV. Provider business mailing address

10543 CHALMER ST
SPRING HILL FL
34609-2411
US

V. Phone/Fax

Practice location:
  • Phone: 352-686-4040
  • Fax: 352-686-1988
Mailing address:
  • Phone: 352-686-4040
  • Fax: 352-686-1988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH12195
License Number StateFL

VIII. Authorized Official

Name: SANDRA L BURR
Title or Position: OFFICE MANAGER
Credential:
Phone: 727-686-4040