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General NPI Number Information
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NPI Number | 1366440893
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Entity Type | Individual
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Provider Name | JEFFREY GRAHAM PITTS DC PA
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Gender | Male
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 09/23/2009
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Provider Practice Location Address
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Address Line | 801 NE 25TH AVE
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City | OCALA
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State | FL
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Zip | 34470-6319
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Country | US
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Telephone | 352-732-0200
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Fax | 352-732-2623
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Provider Business Mailing Address
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Address Line | 801 NE 25TH AVE
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City | OCALA
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State | FL
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Zip | 34470-6319
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Country | US
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Telephone | 352-732-0200
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Fax | 352-732-2623
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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 | CH2867
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License Number State | FL
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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 | CHIR001194
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License Number State | GA
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