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General NPI Number Information
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NPI Number | 1952139073
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Entity Type | Individual
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Provider Name | MIA BACH DC
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Gender | Female
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 1153 MAIN ST STE 105
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City | DUNEDIN
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State | FL
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Zip | 34698-5332
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Country | US
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Telephone | 727-386-8229
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Fax |
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Provider Business Mailing Address
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Address Line | 6207 S WEST SHORE BLVD APT 3036
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City | TAMPA
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State | FL
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Zip | 33616-1657
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 15093
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License Number State | FL
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