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General NPI Number Information
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NPI Number | 1205937364
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Entity Type | Organization
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Legal Business Name | HEALTH SOLUTIONS WELLNESS CENTER LLC
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 1514 S ALEXANDER ST SUITE 106
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City | PLANT CITY
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State | FL
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Zip | 33563-8414
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Country | US
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Telephone | 813-717-7553
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Fax | 813-717-7593
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Provider Business Mailing Address
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Address Line | 1514 S ALEXANDER ST SUITE 106
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City | PLANT CITY
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State | FL
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Zip | 33563-8414
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Country | US
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Telephone | 813-717-7553
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Fax | 813-717-7593
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN BRADLEY SOUTHER
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Credential | DC
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Telephone | 813-717-7553
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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 | CH-8722
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License Number State | FL
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