Provider Demographics
NPI:1770220501
Name:STRENGTH & SPINE CHIROPRACTIC
Entity type:Organization
Organization Name:STRENGTH & SPINE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:
Authorized Official - Last Name:GHOLAMPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-517-6266
Mailing Address - Street 1:4416 BARDSDALE DR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-2600
Mailing Address - Country:US
Mailing Address - Phone:727-517-6266
Mailing Address - Fax:
Practice Address - Street 1:14210 N NEBRASKA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-2219
Practice Address - Country:US
Practice Address - Phone:727-228-3030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1093343303OtherNPI