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Organization
SAGE CAMPIONE, DCPA
Active
Organization
SAGE CAMPIONE, DCPA
Active
Other names
Axis Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
GARY JOHN KOTILA DC (PRESIDENT)
(813) 643-1242
Entity
Organization
Contact information
Practice address
330 PAULS DR, SUITE 102, BRANDON, FL 33511-4801
(813) 643-1242
(813) 643-1246
Mailing address
330 PAULS DR, SUITE 102, BRANDON, FL 33511-4801
(813) 643-1242
(813) 643-1246
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH8164
FL
111N00000X
Chiropractor
Primary
CH9719
FL
Other
Enumeration date
12/13/2006
Last updated
02/26/2010
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