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General NPI Number Information
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NPI Number | 1174802136
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Entity Type | Organization
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Legal Business Name | ALL GENTLE CHIROPRACTIC PA
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 11/02/2011
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Provider Practice Location Address
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Address Line | 3535 US HIGHWAY 17 STE 11
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-7139
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Country | US
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Telephone | 904-644-8100
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Fax | 904-644-8101
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Provider Business Mailing Address
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Address Line | 3535 US HIGHWAY 17 STE 11
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-7139
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Country | US
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Telephone | 904-644-8100
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Fax | 904-644-8101
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Authorized Official
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Title or Position | PRESIDENT/CHIROPRACTOR
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Name | DR. JUNE GENTLE
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Credential | D.C.
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Telephone | 305-458-3525
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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 | CH7065
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License Number State | FL
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