Provider Demographics
NPI:1144570649
Name:APOLLO BEACH CHIROPRACTIC WELLNESS, P.A.
Entity Type:Organization
Organization Name:APOLLO BEACH CHIROPRACTIC WELLNESS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-641-3333
Mailing Address - Street 1:100 FRANDORSON CIR
Mailing Address - Street 2:STE 101
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-2659
Mailing Address - Country:US
Mailing Address - Phone:813-641-3333
Mailing Address - Fax:813-641-0843
Practice Address - Street 1:100 FRANDORSON CIR
Practice Address - Street 2:STE 101
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-2659
Practice Address - Country:US
Practice Address - Phone:813-641-3333
Practice Address - Fax:813-641-0843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty