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General NPI Number Information
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NPI Number | 1093314163
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Entity Type | Organization
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Legal Business Name | LOVING CARE PEDIATRIC THERAPY
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 140 PINE AVE N
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City | OLDSMAR
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State | FL
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Zip | 34677-4629
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Country | US
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Telephone | 970-394-4316
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Fax |
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Provider Business Mailing Address
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Address Line | 140 PINE AVE N
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City | OLDSMAR
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State | FL
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Zip | 34677-4629
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Country | US
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Telephone | 813-343-0436
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Fax | 813-441-8982
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Authorized Official
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Title or Position | PARTNER
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Name | DR. THOMAS JOHN O'HARA II
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Credential | DC
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Telephone | 970-394-4316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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