MEDICARE: PREMIER CHIROPRACTIC AND WELLNESS CENTER PLC

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
1	171100000X	Acupuncturist	CH8655	FL
2	111N00000X	Chiropractor	CH8655	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	889041	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1134393804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER CHIROPRACTIC AND WELLNESS CENTER PLC

Provider Business Mailing Address
First Line	:	3500 BEACHWOOD CT
Second Line	:	SUITE 203
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-5706
Country	:	US
Telephone Number	:	904-996-6922
Fax Number	:	904-996-6923

Provider Business Practice Location Address
First Line	:	3500 BEACHWOOD CT
Second Line	:	SUITE 203
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-5706
Country	:	US
Telephone Number	:	904-996-6922
Fax Number	:	904-996-6923

Authorized Official
Title or Position	:	CHIROPRACTIC PHYSICIAN
Name	:	DR. KIM MICHELLE JOHNSTON
Credential	:	D.C.
Telephone Number	:	904-996-6922

Provider Enumeration Date	:	04/14/2008
Last Update Date	:	10/06/2008

Similar Medicare Providers

1750422606 — MR. NORMAN E MARASIGAN D.P.T.
Practice Location Address:

3500 BEACHWOOD CT , SUITE 203
JACKSONVILLE, FL
32224-5706

Practice Phone: 904-996-6922
Practice Fax: 904-996-6923

1437321767 — MR. CHRISTOPHER K KOPP PT
Practice Location Address:

3500 BEACHWOOD CT , SUITE 203
JACKSONVILLE, FL
32224-5706

Practice Phone: 904-996-6922
Practice Fax: 904-996-6923

1053576975 — MR. ERIC D MASON PT
Practice Location Address:

3500 BEACHWOOD CT , SUITE 203
JACKSONVILLE, FL
32224-5706

Practice Phone: 904-996-6922
Practice Fax: 904-996-6923

1841737772 — FIRST COAST SPEECH SERVICES, LLC
Practice Location Address:

2662 MCCORMICK WOODS DR
JACKSONVILLE, FL
32225-5706

Practice Phone: 904-755-1418
Practice Fax:

1114760246 — 5TH ESSENTIALS LLC
Practice Location Address:

5706 BLACKTHORN RD
JACKSONVILLE, FL
32244-2008

Practice Phone: 904-385-3288
Practice Fax:

1346083284 — JOSIE JACKSON LMT
Practice Location Address:

5706 BLACKTHORN RD
JACKSONVILLE, FL
32244-2008

Practice Phone: 210-999-0960
Practice Fax:

Directions to “PREMIER CHIROPRACTIC AND WELLNESS CENTER PLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.