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General NPI Number Information
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NPI Number | 1205021086
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC CLINICS, INC.
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Dates
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Enumeration Date | 09/13/2007
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 516 PATRICIA AVE
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City | DUNEDIN
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State | FL
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Zip | 34698-7813
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Country | US
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Telephone | 727-736-1000
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Fax | 727-736-3556
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Provider Business Mailing Address
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Address Line | 516 PATRICIA AVE
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City | DUNEDIN
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State | FL
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Zip | 34698-7813
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Country | US
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Telephone | 727-736-1000
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Fax | 727-736-3556
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | LYNN COLUCCI
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Credential | DC
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Telephone | 727-736-1000
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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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