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General NPI Number Information
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NPI Number | 1841590791
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Entity Type | Organization
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Legal Business Name | MICHAEL T. COYLE, DC, PA
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 10/26/2010
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Provider Practice Location Address
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Address Line | 1131 BARTOW RD
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City | LAKELAND
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State | FL
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Zip | 33801-5949
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Country | US
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Telephone | 863-687-4540
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Fax | 863-683-0830
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Provider Business Mailing Address
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Address Line | 1131 BARTOW RD
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City | LAKELAND
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State | FL
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Zip | 33801-5949
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Country | US
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Telephone | 863-687-4540
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Fax | 863-683-0830
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL T. COYLE
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Credential | D.C.
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Telephone | 863-687-4540
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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 | CH7409
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License Number State | FL
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