Provider Demographics
NPI:1235662636
Name:TKD HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:TKD HEALTHCARE SERVICES
Other - Org Name:DRIVERS HEALTH CLINC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:JUNE
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:DC RD LDN
Authorized Official - Phone:352-643-1034
Mailing Address - Street 1:4470 VERMILLION SKY DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7375
Mailing Address - Country:US
Mailing Address - Phone:727-457-6627
Mailing Address - Fax:
Practice Address - Street 1:556 E SR 44
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:FL
Practice Address - Zip Code:34785-9474
Practice Address - Country:US
Practice Address - Phone:352-643-1034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11281111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Single Specialty