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General NPI Number Information
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NPI Number | 1669894085
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Entity Type | Organization
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Legal Business Name | JESSE LEE ANGLE II D.C., PA
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Dates
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Enumeration Date | 01/21/2014
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Last Update Date | 01/21/2014
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Provider Practice Location Address
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Address Line | 871 DONALD ROSS RD
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City | JUNO BEACH
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State | FL
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Zip | 33408-1606
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Country | US
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Telephone | 561-632-0871
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Fax |
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Provider Business Mailing Address
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Address Line | 871 DONALD ROSS RD
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City | JUNO BEACH
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State | FL
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Zip | 33408-1606
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Country | US
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Telephone | 561-632-0871
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JESSE LEE ANGLE II
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Credential | D.C.
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Telephone | 561-632-0871
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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 | CH11021
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License Number State | FL
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