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General NPI Number Information
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NPI Number | 1013293869
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Entity Type | Organization
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Legal Business Name | STRONGLIFE CHIROPRACTIC & NATURAL HEALTH, P.A.
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Dates
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Enumeration Date | 10/25/2011
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Last Update Date | 12/01/2015
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Provider Practice Location Address
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Address Line | 5618 FISHHAWK CROSSING BLVD
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City | LITHIA
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State | FL
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Zip | 33547-5900
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Country | US
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Telephone | 813-655-5433
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Fax | 813-655-5488
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Provider Business Mailing Address
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Address Line | 5618 FISHHAWK CROSSING BLVD
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City | LITHIA
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State | FL
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Zip | 33547-5900
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Country | US
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Telephone | 813-655-5433
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Fax | 813-655-5488
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JUSTIN RYAN SCOTT
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Credential | DC
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Telephone | 813-655-5433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | CH9598
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License Number State | FL
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