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General NPI Number Information
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NPI Number | 1831275577
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Entity Type | Organization
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Legal Business Name | SAN MARCO CHIROPRACTIC AND WELLNESS CENTER
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 05/09/2013
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Provider Practice Location Address
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Address Line | 1517 LANDON AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8654
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Country | US
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Telephone | 904-396-1737
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Fax | 904-396-7172
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Provider Business Mailing Address
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Address Line | 1517 LANDON AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8654
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Country | US
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Telephone | 904-396-1737
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Fax | 904-396-7172
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JEFFREY ROSKEIN
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Credential | DC
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Telephone | 904-396-1737
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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 |
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License Number State |
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