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NPI Code Detail

MEDICARE: JACKSONVILLE CHIROPRACTIC & ACUPUNCTURE LLC

MEDICARE: JACKSONVILLE CHIROPRACTIC & ACUPUNCTURE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCH9264FL
2111N00000XChiropractor

General Provider Information

NPI Number : 1023347093
Entity Type Code : Organization
Provider Name (Legal Business Name) : JACKSONVILLE CHIROPRACTIC & ACUPUNCTURE LLC
Provider Business Mailing Address
First Line : 13770 BEACH BLVD STE 4
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-7227
Country : US
Telephone Number : 904-619-2703
Fax Number : 904-619-2837
Provider Business Practice Location Address
First Line : 13770 BEACH BLVD STE 4
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-7227
Country : US
Telephone Number : 904-619-2703
Fax Number : 904-619-2837
Authorized Official
Title or Position : OWNER
Name : DR. JEREMIAH WESLEY CARLSON
Credential : D.C.
Telephone Number : 904-382-6763
Provider Enumeration Date : 12/21/2009
Last Update Date : 05/13/2022

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Directions to “JACKSONVILLE CHIROPRACTIC & ACUPUNCTURE LLC ” Practice Location

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