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General NPI Number Information
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NPI Number | 1245209287
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Entity Type | Organization
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Legal Business Name | SF CHIROPRACTIC & REHAB CENTER, INC
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 2312 CRESTOVER LN STE 101
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6790
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Country | US
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Telephone | 813-501-8091
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Fax | 813-803-4729
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Provider Business Mailing Address
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Address Line | 4121 N ARMENIA AVE
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City | TAMPA
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State | FL
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Zip | 33607-6433
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Country | US
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Telephone | 813-350-9100
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Fax | 813-374-8929
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YONG H KIM
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Credential | D.C., D.A.C.N.B.
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Telephone | 813-350-9100
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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 | CH6830
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License Number State | FL
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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 | CH9101
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License Number State | FL
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