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General NPI Number Information
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NPI Number | 1417133570
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Entity Type | Organization
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Legal Business Name | ERIKA N. BETHUNE, D.C., P.A.
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Dates
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Enumeration Date | 01/18/2008
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Last Update Date | 01/18/2008
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Provider Practice Location Address
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Address Line | 6406 E FOWLER AVE SUITE D
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-2400
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Country | US
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Telephone | 813-985-9191
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Fax | 813-980-2354
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Provider Business Mailing Address
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Address Line | 6406 E FOWLER AVE SUITE D
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-2400
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Country | US
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Telephone | 813-985-9191
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Fax | 813-980-2354
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIKA NICOLE BETHUNE
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Credential | D.C.
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Telephone | 813-985-9191
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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 | CH0007722
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License Number State | FL
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