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General NPI Number Information
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NPI Number | 1023751534
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Entity Type | Organization
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Legal Business Name | BB CHIROPRACTIC LLC
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 357 WEKIVA SPRINGS RD STE 3
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City | LONGWOOD
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State | FL
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Zip | 32779-3607
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Country | US
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Telephone | 407-308-2979
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Fax |
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Provider Business Mailing Address
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Address Line | 940 VILLAGE TRL UNIT 4-302
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City | PORT ORANGE
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State | FL
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Zip | 32127-9380
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Country | US
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Telephone | 507-531-6476
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIATTA BUNTJER
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Credential | DC
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Telephone | 407-308-2979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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