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General NPI Number Information
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NPI Number | 1669152906
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Entity Type | Organization
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Legal Business Name | HEALTH IN MOTION CHIROPRACTIC AND REHABILITATION, LLC
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Dates
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Enumeration Date | 07/21/2023
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Last Update Date | 10/08/2023
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Provider Practice Location Address
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Address Line | 2029 OSPREY LN STE B
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City | LUTZ
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State | FL
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Zip | 33549-9361
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Country | US
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Telephone | 813-254-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 2029 OSPREY LN STE B
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City | LUTZ
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State | FL
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Zip | 33549-9361
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Country | US
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Telephone | 716-310-9355
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | AL BERRY
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Credential | DC
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Telephone | 321-320-7512
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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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