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General NPI Number Information
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NPI Number | 1982898318
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Entity Type | Organization
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Legal Business Name | BACK IN HEALTH WELLNESS CENTER LLC
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 01/05/2008
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Provider Practice Location Address
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Address Line | 18942 DALE MABRY HWY N SUITE 102
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City | LUTZ
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State | FL
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Zip | 33548-4907
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Country | US
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Telephone | 813-909-0961
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Fax | 813-909-2086
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Provider Business Mailing Address
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Address Line | 18942 DALE MABRY HWY N SUITE 102
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City | LUTZ
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State | FL
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Zip | 33548-4907
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Country | US
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Telephone | 813-909-0961
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Fax | 813-909-2086
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. CINDY LEIGH PERKINS
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Credential | D.C.
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Telephone | 813-909-0961
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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 | FL
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