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General NPI Number Information
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NPI Number | 1720138035
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Entity Type | Organization
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Legal Business Name | ALTOMARE CHIROPRACTIC CENTER PA
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 06/04/2008
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Provider Practice Location Address
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Address Line | 10175 FORTUNE PKWY SUITE 1001
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6746
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Country | US
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Telephone | 904-464-0319
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Fax | 904-464-0672
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Provider Business Mailing Address
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Address Line | 10175 FORTUNE PKWY STE 1001
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6746
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Country | US
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Telephone | 904-464-0319
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Fax | 904-464-0672
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH J ALTOMARE
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Credential | DC
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Telephone | 904-464-0319
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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 | CH4855
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License Number State | FL
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