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General NPI Number Information
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NPI Number | 1851587323
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Entity Type | Organization
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Legal Business Name | FT CAROLINE CHIROPRACTIC CLINIC PA
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 12086 FORT CAROLINE RD SUITE 302
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City | JACKSONVILLE
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State | FL
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Zip | 32225-2687
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Country | US
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Telephone | 904-564-2500
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Fax | 904-564-2566
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Provider Business Mailing Address
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Address Line | 12086 FORT CAROLINE RD SUITE 302
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City | JACKSONVILLE
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State | FL
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Zip | 32225-2687
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Country | US
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Telephone | 904-564-2500
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Fax | 904-564-2566
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Authorized Official
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Title or Position | PRESIDENT/ DIRECTOR
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Name | AMY D SESSIONS
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Credential | DC
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Telephone | 904-564-2500
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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 | CH8005
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License Number State | FL
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