Provider Demographics
NPI:1730356411
Name:CHALLENGE ME LLC
Entity type:Organization
Organization Name:CHALLENGE ME LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-749-8940
Mailing Address - Street 1:3970 TAMPA RD
Mailing Address - Street 2:SUITE DHTTPS://NPPES.CMS.HHS.GOV/NPPES/LOGOFF.DO
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3201
Mailing Address - Country:US
Mailing Address - Phone:813-749-8940
Mailing Address - Fax:
Practice Address - Street 1:3970 TAMPA RD
Practice Address - Street 2:SUITE D
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-3201
Practice Address - Country:US
Practice Address - Phone:813-749-8940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7894111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty