Dr Kevin Matthew O'donnell, DC | |
304 Kingsley Lake Dr Ste 603, St Augustine, FL 32092-3042 | |
(904) 342-4242 | |
(904) 342-4243 |
Full Name | Dr Kevin Matthew O'donnell |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 304 Kingsley Lake Dr Ste 603, St Augustine, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1457884876 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 12145 (Florida) | Primary |
Provider Name | Carolina Totalcare Pa |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1891116976 PECOS PAC ID: 2365666757 Enrollment ID: O20140604001390 |
Mailing Address | Practice Location Address |
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Dr Kevin Matthew O'donnell, DC 304 Kingsley Lake Dr Ste 603, St Augustine, FL 32092-3042 Ph: (904) 342-4242 | Dr Kevin Matthew O'donnell, DC 304 Kingsley Lake Dr Ste 603, St Augustine, FL 32092-3042 Ph: (904) 342-4242 |
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