Organization
LIVE STRONGER BUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNICE SIMMONS (PARTNER)
(813) 466-8793
Entity
Organization
Contact information
Practice address
8602 TEMPLE TERRACE HWY, D-36, TAMPA, FL 33637-5802
(813) 466-8793
Mailing address
8602 TEMPLE TERRACE HWY, D-36, TAMPA, FL 33637-5802
(813) 466-8793
Taxonomy
Speciality
Code
Description
License number
State
163WR0400X
Rehabilitation Registered Nurse
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
01/21/2018
Last updated
01/21/2018
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