Healthcare Provider Details

I. General information

NPI: 1609708536
Provider Name (Legal Business Name): BRYCE NEWLAND DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 KINGSLEY AVE
ORANGE PARK FL
32073-4527
US

IV. Provider business mailing address

1413 KINGSLEY AVE
ORANGE PARK FL
32073-4527
US

V. Phone/Fax

Practice location:
  • Phone: 904-264-3966
  • Fax: 904-278-7171
Mailing address:
  • Phone: 904-264-3966
  • Fax: 904-278-7171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH15973
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: