Organization
IMPACT MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA N BOTBYL (ADMINISTRATOR)
(727) 272-4919
Entity
Organization
Contact information
Practice address
2014 ASHLEY OAKS CIR, WESLEY CHAPEL, FL 33544-6400
(813) 953-1002
Mailing address
PO BOX 7982, SEMINOLE, FL 33775-7982
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
03/06/2019
Last updated
02/28/2022
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