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General NPI Number Information
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NPI Number | 1750618245
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE CHIROPRACTIC FUSION
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Dates
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Enumeration Date | 11/04/2009
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Last Update Date | 03/05/2010
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Provider Practice Location Address
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Address Line | 9564 118TH LN
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City | SEMINOLE
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State | FL
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Zip | 33772-2705
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Country | US
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Telephone | 727-504-6931
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Fax |
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Provider Business Mailing Address
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Address Line | 9225 ULMERTON RD #306
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City | LARGO
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State | FL
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Zip | 33771-3751
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Country | US
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Telephone | 727-386-4004
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Fax | 727-386-4090
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. HOLLY CHRISTINA FURLONG
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Credential | D.C
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Telephone | 727-386-4004
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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 | CH 9841
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License Number State | FL
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