Organization
CG1 CHIROPRACTIC CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMINADOR REYNO UY JR. (CHIROPRACTIC PHYSICIAN)
(813) 909-7171
Entity
Organization
Contact information
Practice address
16102 N FLORIDA AVE, LUTZ, FL 33549-6129
(813) 909-7171
Mailing address
16102 N FLORIDA AVE, LUTZ, FL 33549-6129
(813) 909-7171
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH8278
FL
Other
Enumeration date
08/21/2007
Last updated
09/21/2012
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