MEDICARE: SAN MARCO CHIROPRACTIC AND WELLNESS CENTER

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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1831275577
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN MARCO CHIROPRACTIC AND WELLNESS CENTER

Provider Business Mailing Address
First Line	:	1517 LANDON AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-8654
Country	:	US
Telephone Number	:	904-396-1737
Fax Number	:	904-396-7172

Provider Business Practice Location Address
First Line	:	1517 LANDON AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-8654
Country	:	US
Telephone Number	:	904-396-1737
Fax Number	:	904-396-7172

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. JEFFREY ROSKEIN
Credential	:	DC
Telephone Number	:	904-396-1737

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	05/09/2013

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Directions to “SAN MARCO CHIROPRACTIC AND WELLNESS CENTER ” Practice Location

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