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General NPI Number Information
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NPI Number | 1972142552
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Entity Type | Organization
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Legal Business Name | INTEGRATED SPINE AND PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 12/31/2019
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Last Update Date | 12/31/2019
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Provider Practice Location Address
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Address Line | 3717 TURMAN LOOP STE 101A
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-7794
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Country | US
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Telephone | 813-994-5200
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Fax | 813-994-5700
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Provider Business Mailing Address
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Address Line | 31609 HOLCOMB PASS
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-5210
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Country | US
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Telephone | 574-536-9511
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT BOYD AMIS JR.
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Credential | DC
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Telephone | 574-536-9511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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