Organization
MIND & BODY CLINIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL J RUTLEDGE NMT, ACCUP, MSOM (OWNER)
(704) 264-5626
Entity
Organization
Contact information
Practice address
7229 CENTRAL AVE, ST PETERSBURG, FL 33710-7413
(727) 258-4786
Mailing address
7229 CENTRAL AVE, ST PETERSBURG, FL 33710-7413
(727) 258-4786
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
MA59841
FL
Other
Enumeration date
05/16/2018
Last updated
05/16/2018
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