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General NPI Number Information
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NPI Number | 1912531229
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Entity Type | Organization
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Legal Business Name | MAXIMUM HEALTH CLINIC OF CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 02/25/2020
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Last Update Date | 09/09/2021
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Provider Practice Location Address
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Address Line | 6615 49TH ST N
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City | PINELLAS PARK
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State | FL
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Zip | 33781
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Country | US
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Telephone | 727-800-2036
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Fax |
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Provider Business Mailing Address
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Address Line | 11050 106TH AVE
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City | SEMINOLE
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State | FL
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Zip | 33778-4016
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Country | US
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Telephone | 517-745-3395
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER/OWNER
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Name | SARAH PALON
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Credential |
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Telephone | 517-745-3395
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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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