Organization
BAIN COMPLETE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSANNE F WITT (VP, OPERATIONS)
(813) 574-2460
Entity
Organization
Contact information
Practice address
10311 CROSS CREEK BLVD, SUITE E, TAMPA, FL 33647-2989
(813) 907-9898
(813) 907-0220
Mailing address
1868 HIGHLAND OAKS BLVD STE B, LUTZ, FL 33559-7413
(813) 574-2460
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
10/01/2014
Last updated
10/01/2014
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