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General NPI Number Information
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NPI Number | 1720437460
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Entity Type | Organization
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Legal Business Name | CHIROCURE HEALTH CENTER LLC
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Dates
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Enumeration Date | 06/03/2016
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Last Update Date | 06/03/2016
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Provider Practice Location Address
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Address Line | 8833 PERIMETER PARK BLVD SUITE 102
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City | JACKSONVILLE
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State | FL
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Zip | 32216-1109
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Country | US
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Telephone | 904-616-8454
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Fax |
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Provider Business Mailing Address
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Address Line | 8833 PERIMETER PARK BLVD SUITE 102
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City | JACKSONVILLE
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State | FL
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Zip | 32216-1109
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Country | US
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Telephone | 904-616-8454
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. EMILIO COSIO
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Credential | D.C.
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Telephone | 904-616-8454
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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 | CH10964
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License Number State | FL
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