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General NPI Number Information
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NPI Number | 1790127603
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Entity Type | Organization
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Legal Business Name | ANY ACCIDENT CARE CLINIC PLLC
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Dates
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Enumeration Date | 07/19/2013
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 607 W DR MARTIN LUTHER KING JR BLVD SUITE 101
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City | TAMPA
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State | FL
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Zip | 33603-3453
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Country | US
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Telephone | 727-474-9729
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Fax | 727-499-7899
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Provider Business Mailing Address
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Address Line | 607 W. DR. MARTIN LUTHER KING JR. BLVD SUITE 101
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City | TAMPA
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State | FL
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Zip | 33603
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Country | US
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Telephone | 727-474-9729
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Fax | 727-499-7899
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | ERIC KRISTIAN GROTEKE
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Credential | D.C.
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Telephone | 727-474-9729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | CH 8772
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License Number State | FL
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