Provider Demographics
NPI:1548291149
Name:UNDERWOOD HEALTHCARE SERVICES, INC.
Entity type:Organization
Organization Name:UNDERWOOD HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDELL
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-885-1364
Mailing Address - Street 1:7902 W WATERS AVE
Mailing Address - Street 2:G & H
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-1817
Mailing Address - Country:US
Mailing Address - Phone:813-885-1364
Mailing Address - Fax:813-885-1365
Practice Address - Street 1:7902 W WATERS AVE
Practice Address - Street 2:G & H
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-1817
Practice Address - Country:US
Practice Address - Phone:813-885-1364
Practice Address - Fax:813-885-1365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7089111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty