| NPI | 1598159576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD ROSE Owner 352-775-2180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL 053562) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH11031) |
| 225100000X Physical Therapist | |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2022-08-30 |