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General NPI Number Information
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NPI Number | 1659810067
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Entity Type | Organization
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Legal Business Name | ONE HOLISTIC HEALTH CLINIC.LLC
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Dates
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Enumeration Date | 02/17/2017
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Last Update Date | 02/17/2017
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Provider Practice Location Address
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Address Line | 601 N LOIS AVE STE 23
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City | TAMPA
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State | FL
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Zip | 33609-2216
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Country | US
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Telephone | 813-858-7418
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Fax |
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Provider Business Mailing Address
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Address Line | 601 N LOIS AVE SUITE 23
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City | TAMPA
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State | FL
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Zip | 33609-1731
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Country | US
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Telephone | 813-858-7418
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUNE HYUN MI HWANG
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Credential | DPT
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Telephone | 813-858-7418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT26315
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License Number State | FL
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