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General NPI Number Information
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NPI Number | 1972797579
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Entity Type | Organization
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Legal Business Name | D.C. DEWEESE, P.A.
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 03/19/2014
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Provider Practice Location Address
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Address Line | 1312 DUNN AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32218-4836
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Country | US
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Telephone | 904-757-4786
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Fax | 904-757-4882
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Provider Business Mailing Address
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Address Line | 1312 DUNN AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32218-4836
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Country | US
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Telephone | 904-757-4786
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Fax | 904-757-4882
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. DAMON CHRIS DEWEESE
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Credential | D.C.
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Telephone | 904-757-4786
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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 | CH8089
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License Number State | FL
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