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General NPI Number Information
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NPI Number | 1245689090
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Entity Type | Organization
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Legal Business Name | HUNT HOLISTIC CHIROPRACTIC, INC
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Dates
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Enumeration Date | 06/11/2016
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Last Update Date | 06/11/2016
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Provider Practice Location Address
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Address Line | 2029 OSPREY LN STE B
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City | LUTZ
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State | FL
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Zip | 33549-9361
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Country | US
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Telephone | 847-609-0053
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Fax |
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Provider Business Mailing Address
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Address Line | 1230 ROLLING STONE RUN
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City | ODESSA
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State | FL
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Zip | 33556-6039
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JASON EDWARD HUNT
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Credential | D.C.
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Telephone | 847-609-0053
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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 | CH11857
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License Number State | FL
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