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General NPI Number Information
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NPI Number | 1740301613
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Entity Type | Organization
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Legal Business Name | GULF BREEZE CHIROPRACTIC PA D/B/A HALL CHIROPRACTIC & SPORTS MEDICINE
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/05/2011
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Provider Practice Location Address
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Address Line | 1101 GULF BREEZE PKWY SUITE 106
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City | GULF BREEZE
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State | FL
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Zip | 32561-4862
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Country | US
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Telephone | 850-924-4255
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Fax | 850-934-9868
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Provider Business Mailing Address
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Address Line | PO BOX 30195
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City | PENSACOLA
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State | FL
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Zip | 32503-1195
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Country | US
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Telephone | 850-934-4255
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Fax | 850-934-9868
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | DR. JASON DURWOOD HALL
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Credential | D.C.
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Telephone | 850-934-4255
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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 | CH0008747
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License Number State | FL
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