| NPI | 1174622880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONJE STEVENS Adm. 727-518-2977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH7815) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH9310) |
| 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: FL OS 8925) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |