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General NPI Number Information
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NPI Number | 1336405521
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Entity Type | Organization
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Legal Business Name | JEFFERY J. KROMOLICKI PA
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Dates
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Enumeration Date | 04/02/2012
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 2019 LITTLE RD
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City | TRINITY
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State | FL
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Zip | 34655-4421
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Country | US
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Telephone | 727-375-7557
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Fax | 727-375-9958
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Provider Business Mailing Address
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Address Line | 2019 LITTLE RD
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City | TRINITY
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State | FL
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Zip | 34655-4421
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Country | US
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Telephone | 727-375-7557
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Fax | 727-375-9958
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Authorized Official
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Title or Position | OWNER
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Name | JEFFERY JOSEPH KROMOLICKI
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Credential | DC
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Telephone | 727-375-7557
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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 | CH7844
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License Number State | FL
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