Healthcare Provider Details

I. General information

NPI: 1063326908
Provider Name (Legal Business Name): CHP JACKSONVILLE CLINICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11048 BAYMEADOWS RD UNIT 2
JACKSONVILLE FL
32256-9583
US

IV. Provider business mailing address

11048 BAYMEADOWS RD UNIT 2
JACKSONVILLE FL
32256-9583
US

V. Phone/Fax

Practice location:
  • Phone: 904-733-7393
  • Fax:
Mailing address:
  • Phone: 904-733-7393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ALAN NATHANS
Title or Position: OWNER
Credential: DC
Phone: 904-733-7393