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NPI Code Detail

MEDICARE: BAYMEADOWS CHIROPRACTIC AND PHYSICAL THERAPY LLC

MEDICARE: BAYMEADOWS CHIROPRACTIC AND PHYSICAL THERAPY 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
1111N00000XChiropractorCH9245FL
2111N00000XChiropractorCH9601FL

General Provider Information

NPI Number : 1891920138
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAYMEADOWS CHIROPRACTIC AND PHYSICAL THERAPY LLC
Provider Business Mailing Address
First Line : 2220 COUNTY ROAD 210 W
Second Line : SUITE 108, BOX 327
City : SAINT JOHNS
State : FL
Zip : 32259-4058
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8206 PHILIPS HWY
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-1220
Country : US
Telephone Number : 904-673-9691
Fax Number :
Authorized Official
Title or Position : MGRM
Name : AGOSTINHO OLIVEIRA
Credential : DC
Telephone Number : 904-673-9691
Provider Enumeration Date : 05/15/2009
Last Update Date : 05/15/2009

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Directions to “BAYMEADOWS CHIROPRACTIC AND PHYSICAL THERAPY LLC ” Practice Location

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