Provider Demographics
NPI:1356011449
Name:ACUTE INJURY & WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:ACUTE INJURY & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:813-898-8661
Mailing Address - Street 1:7827 N DALE MABRY HWY STE 108
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-3222
Mailing Address - Country:US
Mailing Address - Phone:813-898-8661
Mailing Address - Fax:813-513-3279
Practice Address - Street 1:7827 N DALE MABRY HWY STE 108
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3222
Practice Address - Country:US
Practice Address - Phone:813-898-8661
Practice Address - Fax:813-513-3279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH8249OtherCHIROPRACTIC SERVICES