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General NPI Number Information
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NPI Number | 1285107128
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Entity Type | Organization
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Legal Business Name | FUNCTIONAL THERAPIES, LLC
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Dates
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Enumeration Date | 01/03/2019
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 6770 US HIGHWAY 27 N
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City | SEBRING
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State | FL
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Zip | 33870-0600
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Country | US
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Telephone | 863-382-0830
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Fax | 863-382-0831
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Provider Business Mailing Address
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Address Line | 6770 US HIGHWAY 27 N
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City | SEBRING
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State | FL
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Zip | 33870-0600
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Country | US
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Telephone | 863-382-0830
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Fax | 863-382-0831
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. TAMIKA DIONNE SIMS
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Credential | DC
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Telephone | 863-382-0830
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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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