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General NPI Number Information
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NPI Number | 1902151814
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Entity Type | Organization
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Legal Business Name | WELLNESS WAY TAMPA LLC
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 02/17/2015
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Provider Practice Location Address
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Address Line | 27552 CASHFORD CIR SUITE 101
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6951
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Country | US
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Telephone | 813-973-8883
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Fax | 813-762-1413
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Provider Business Mailing Address
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Address Line | 27552 CASHFORD CIR SUITE 101
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6951
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Country | US
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Telephone | 813-996-4773
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Fax | 813-762-1413
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. THOMAS W. MYERS
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Credential | DC, ATC
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Telephone | 813-996-4773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | CH9195
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License Number State | FL
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