Tillman Family Chiropractic, LLC
Organization Active NPI Chiropractor · Freeport, FL
NPI 1174371017 · NPPES record last updated May 7, 2024
Key facts
- NPI
- 1174371017
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- TILLMAN FAMILY CHIROPRACTIC, LLC
- Practice address
- 13295 Business 331
Suite A300
Freeport, FL 32439 - Phone
- (850) 270-1709
- NPI assigned
- May 7, 2024
- Organization subpart
- No
Authorized official
- Name
- Travis C Tillman, DC
- Title
- Owner/Chiropractor
- Phone
- (850) 419-9191
Practitioners 1
-
Travis Christian Tillman, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240730000489 | FL | Part B Supplier - Clinic/Group Practice | 7315484136 |
Receives reassigned benefits from 1 practitioner Practice locations: Freeport, FL |
National Provider Directory
Locations
13295 331 Business
Ste A300
Freeport, FL 32439
Phone (850) 270-1709
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
13295 Business 331
Suite A300
Freeport, FL 32439
Mailing address
13295 Business 331
Suite A300
Freeport, FL 32439
Phone (850) 270-1709
Other providers in Freeport, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.