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General NPI Number Information
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NPI Number | 1265184881
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Entity Type | Individual
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Provider Name | SETH JORDON ALBERSWORTH DC
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Gender | Male
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Dates
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Enumeration Date | 01/25/2022
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 1734 STATE AVE
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City | HOLLY HILL
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State | FL
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Zip | 32117-1748
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Country | US
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Telephone | 386-847-6904
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Fax |
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Provider Business Mailing Address
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Address Line | 4951 ORANGE BLVD
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City | PORT ORANGE
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State | FL
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Zip | 32127-5475
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Country | US
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Telephone | 386-847-6904
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 13903
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License Number State | FL
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