10D2229255 CLIA NUMBER - KOTILA CHIROPRACTIC INC

Laboratory Demographics

CLIA Number: 10D2229255

Facility Name: KOTILA CHIROPRACTIC INC

Facility Address:
1367 OAKFIELD DR
BRANDON, FL
ZIP 33511
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Facility Phone Number: 813 643-1242

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1679874606

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	10D2229255
LAB Type	Physician Office
Facility Name	KOTILA CHIROPRACTIC INC
Street	1367 OAKFIELD DR
City	BRANDON
State	FL
ZIP	33511
Phone	813 643-1242
CertificateType	4
CertificateEffectiveDate	7/9/2023
CertificateExpirationDate	7/8/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024