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General NPI Number Information
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NPI Number | 1295233393
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Entity Type | Organization
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Legal Business Name | BACK TO HEALTH CHIROPRACTIC LLC
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Dates
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Enumeration Date | 01/24/2018
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Last Update Date | 09/04/2018
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Provider Practice Location Address
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Address Line | 3479 DELTONA BLVD
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City | SPRING HILL
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State | FL
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Zip | 34606
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Country | US
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Telephone | 352-340-3220
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Fax | 352-686-4041
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Provider Business Mailing Address
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Address Line | 193 OAK LAKE DR
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City | SPRING HILL
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State | FL
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Zip | 34608-6827
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Country | US
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Telephone | 352-232-3498
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. OLIVIA D'ACUNTO
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Credential | D.C.
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Telephone | 352-232-3498
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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 | CH12386
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License Number State | FL
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