Organization
BAIN DE VIE CORY LAKE ISLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY FILMORE BAIN D.O. (PRESIDENT)
(813) 907-9898
Entity
Organization
Contact information
Practice address
10311 CROSS CREEK BLVD, SUITE E, TAMPA, FL 33647-2989
(813) 907-9898
(813) 907-0220
Mailing address
10311 CROSS CREEK BLVD, SUITE E, TAMPA, FL 33647-2989
(813) 907-9898
(813) 907-0220
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH8562
FL
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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