Healthcare Provider Details

I. General information

NPI: 1639080542
Provider Name (Legal Business Name): JORDAN CHIROPRACTIC & HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 DENNIS ST STE 106
JACKSONVILLE FL
32204-2001
US

IV. Provider business mailing address

1505 DENNIS ST STE 106
JACKSONVILLE FL
32204-2001
US

V. Phone/Fax

Practice location:
  • Phone: 904-617-1532
  • Fax: 904-617-1533
Mailing address:
  • Phone: 904-617-1532
  • Fax: 904-617-1533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JOSHUA JORDAN
Title or Position: OWNER
Credential: D.C.
Phone: 904-624-2800