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General NPI Number Information
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NPI Number | 1043961410
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Entity Type | Organization
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Legal Business Name | OAKLEAF CHIROPRACTIC INC
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Dates
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Enumeration Date | 01/17/2022
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Last Update Date | 01/21/2022
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Provider Practice Location Address
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Address Line | 9785 CROSSHILL BLVD # 108
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City | JACKSONVILLE
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State | FL
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Zip | 32222-5823
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Country | US
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Telephone | 904-772-6522
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Fax | 904-772-6553
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Provider Business Mailing Address
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Address Line | 9785 CROSSHILL BLVD # 108
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City | JACKSONVILLE
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State | FL
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Zip | 32222-5823
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Country | US
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Telephone | 904-772-6522
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Fax | 904-772-6553
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | NATALIE THOMPSON
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Credential |
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Telephone | 904-501-8221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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