MEDICARE: FARRELL & ASSOCIATES DC, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH8685	FL

General Provider Information

NPI Number	:	1891951893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FARRELL & ASSOCIATES DC, PA

Provider Business Mailing Address
First Line	:	6944 W LINEBAUGH AVE
Second Line	:	STE 101
City	:	TAMPA
State	:	FL
Zip	:	33625-5800
Country	:	US
Telephone Number	:	813-265-8555
Fax Number	:	813-265-8645

Provider Business Practice Location Address
First Line	:	6944 W LINEBAUGH AVE
Second Line	:	STE 101
City	:	TAMPA
State	:	FL
Zip	:	33625-5800
Country	:	US
Telephone Number	:	813-265-8555
Fax Number	:	813-265-8645

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THERESA ANNE FARRELL
Credential	:	DC
Telephone Number	:	813-265-8555

Provider Enumeration Date	:	07/30/2008
Last Update Date	:	11/18/2014

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