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General NPI Number Information
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NPI Number | 1679448245
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Entity Type | Organization
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Legal Business Name | JUSTIN TELLO DC PA INC
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 5420 LAND O LAKES BLVD STE 105
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City | LAND O LAKES
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State | FL
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Zip | 34639-3401
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Country | US
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Telephone | 813-996-9800
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Fax | 813-996-9800
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Provider Business Mailing Address
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Address Line | 5420 LAND O LAKES BLVD STE 105
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City | LAND O LAKES
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State | FL
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Zip | 34639-3401
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Country | US
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Telephone | 813-996-9800
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Fax | 813-996-9800
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | KRISTINA NICOLE WEHLAU
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Credential |
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Telephone | 727-418-7288
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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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