Healthcare Provider Details

I. General information

NPI: 1598992240
Provider Name (Legal Business Name): FOLAND CHIROPRACTIC & SPA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2009
Last Update Date: 06/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12428 SAN JOSE BLVD SUITE 2
JACKSONVILLE FL
32223-8616
US

IV. Provider business mailing address

12428 SAN JOSE BLVD SUITE 2
JACKSONVILLE FL
32223-8616
US

V. Phone/Fax

Practice location:
  • Phone: 904-288-8993
  • Fax: 904-288-8995
Mailing address:
  • Phone: 904-288-8993
  • Fax: 904-288-8995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 8793
License Number StateFL

VIII. Authorized Official

Name: DR. WILLIAM STEPHEN FOLAND
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 904-288-8993