Provider Demographics
NPI:1083141840
Name:HYPERBARIC GURU, LLC
Entity Type:Organization
Organization Name:HYPERBARIC GURU, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-566-2751
Mailing Address - Street 1:6752 W GULF TO LAKE HWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429-9348
Mailing Address - Country:US
Mailing Address - Phone:929-374-4268
Mailing Address - Fax:929-214-4268
Practice Address - Street 1:6752 W GULF TO LAKE HWY
Practice Address - Street 2:SUITE 204
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-9348
Practice Address - Country:US
Practice Address - Phone:929-374-4268
Practice Address - Fax:929-214-4268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty