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General NPI Number Information
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NPI Number | 1104229400
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Entity Type | Organization
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Legal Business Name | SELECT HEALTH AND WELLNESS
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 1605 COUNTY ROAD 220 SUITE 165
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-3203
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Country | US
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Telephone | 904-425-9060
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Fax | 904-425-9061
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Provider Business Mailing Address
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Address Line | 1605 COUNTY ROAD 220 STE165
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-4908
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Country | US
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Telephone | 904-425-9060
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Fax | 904-425-9061
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Authorized Official
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Title or Position | OWNER
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Name | JON PAUL FRITZ
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Credential | D.C
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Telephone | 386-697-1355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH10181
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License Number State | FL
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