Provider Demographics
NPI:1871189647
Name:BB WELLNESS
Entity Type:Organization
Organization Name:BB WELLNESS
Other - Org Name:FOUNDATION CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:N
Authorized Official - Last Name:BERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-578-5889
Mailing Address - Street 1:16541 POINTE VILLAGE DR STE 207
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-5259
Mailing Address - Country:US
Mailing Address - Phone:813-578-5889
Mailing Address - Fax:
Practice Address - Street 1:16541 POINTE VILLAGE DR STE 207
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-5259
Practice Address - Country:US
Practice Address - Phone:135-785-8898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty