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General NPI Number Information
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NPI Number | 1083688485
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Entity Type | Organization
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Legal Business Name | SCC GROUP HEALTH CLINIC INCORPORATED
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 1601 RICKENBACKER DR SUITE #2
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-5332
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Country | US
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Telephone | 813-634-8980
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Fax | 813-634-2593
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Provider Business Mailing Address
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Address Line | 1601 RICKENBACKER DR SUITE #2
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-5332
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Country | US
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Telephone | 813-634-8980
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Fax | 813-634-2593
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALLEN THOMAS ZAK
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Credential | D.C.
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Telephone | 813-634-8980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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