Chiro & Laser Pain Relief Center Of St Augustine Llc | |
1092 S Ponce De Leon Blvd Ste K, St Augustine, FL 32084-6018 | |
(904) 460-2923 | |
Not Available |
Full Name | Chiro & Laser Pain Relief Center Of St Augustine Llc |
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Type | Facility |
Speciality | Chiropractor |
Location | 1092 S Ponce De Leon Blvd Ste K, St Augustine, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1114401544 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | (* (Not Available)) | Primary |
Provider Name | Richard Bloom |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1548298250 PECOS PAC ID: 8426095217 Enrollment ID: I20081211000194 |
Provider Name | Gary C Trupo |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1942422126 PECOS PAC ID: 6406838291 Enrollment ID: I20191008000265 |
Mailing Address | Practice Location Address |
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Chiro & Laser Pain Relief Center Of St Augustine Llc 1092 S Ponce De Leon Blvd Ste K, St Augustine, FL 32084-6018 Ph: (904) 460-2923 | Chiro & Laser Pain Relief Center Of St Augustine Llc 1092 S Ponce De Leon Blvd Ste K, St Augustine, FL 32084-6018 Ph: (904) 460-2923 |
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