Provider Demographics
NPI:1033630751
Name:IN LINE CHIROPRACTIC AND WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:IN LINE CHIROPRACTIC AND WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCEI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-565-4445
Mailing Address - Street 1:5668 GULF BREEZE PKWY # B6
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-9524
Mailing Address - Country:US
Mailing Address - Phone:850-565-4445
Mailing Address - Fax:850-565-4446
Practice Address - Street 1:5668 GULF BREEZE PKWY # B6
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-9524
Practice Address - Country:US
Practice Address - Phone:850-565-4445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11781111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty