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General NPI Number Information
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NPI Number | 1205513322
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Entity Type | Organization
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Legal Business Name | MYCHIRO, LLC
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 8763 RIVER CROSSING BLVD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-1112
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Country | US
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Telephone | 135-251-5600
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Fax | 352-610-4387
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Provider Business Mailing Address
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Address Line | 491 MARINER BLVD
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City | SPRING HILL
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State | FL
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Zip | 34609-5680
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Country | US
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Telephone | 352-515-6000
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Fax | 352-610-4387
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | STACY WALKE
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Credential |
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Telephone | 352-515-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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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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