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General NPI Number Information
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NPI Number | 1366983868
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Entity Type | Organization
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Legal Business Name | OMNI TRINITY CHIROPRACTIC CARE LLC
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Dates
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Enumeration Date | 03/16/2017
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 2500 HOLLYWOOD BLVD STE 206
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6615
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Country | US
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Telephone | 786-229-2388
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 HOLLYWOOD BLVD STE 206
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6615
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Country | US
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Telephone | 786-229-2388
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ORIENTALOS VOLMAR
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Credential |
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Telephone | 754-229-2388
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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 | CH11720
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License Number State | FL
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