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NPI Code Detail

MEDICARE: OAKLEAF CHIROPRACTIC INC

MEDICARE: OAKLEAF CHIROPRACTIC INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician
2111N00000XChiropractor

General Provider Information

NPI Number : 1043961410
Entity Type Code : Organization
Provider Name (Legal Business Name) : OAKLEAF CHIROPRACTIC INC
Provider Business Mailing Address
First Line : 9785 CROSSHILL BLVD # 108
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32222-5823
Country : US
Telephone Number : 904-772-6522
Fax Number : 904-772-6553
Provider Business Practice Location Address
First Line : 9785 CROSSHILL BLVD # 108
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32222-5823
Country : US
Telephone Number : 904-772-6522
Fax Number : 904-772-6553
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : NATALIE THOMPSON
Credential :
Telephone Number : 904-501-8221
Provider Enumeration Date : 01/17/2022
Last Update Date : 01/21/2022

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Directions to “OAKLEAF CHIROPRACTIC INC ” Practice Location

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