Provider Demographics
NPI:1821565359
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 1:12 CALLE TRAVIESA
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32561-2412
Mailing Address - Country:US
Mailing Address - Phone:850-207-0165
Mailing Address - Fax:
Practice Address - Street 1:5668 GULF BREEZE PKWY UNIT 6
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-4107
Practice Address - Country:US
Practice Address - Phone:850-565-4445
Practice Address - Fax:850-565-4446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty