| Lighthouse Chiropractic Llc | |
|
145 Hilden Rd, Suite 123, Ponte Vedra, FL 32081-8401 | |
| (904) 395-5371 | |
| Not Available |
| Full Name | Lighthouse Chiropractic Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 145 Hilden Rd, Ponte Vedra, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730629528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Mayredlis Cruz Martir |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1245779818 PECOS PAC ID: 3274883855 Enrollment ID: I20180830003435 |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Chiropractic Llc 145 Hilden Rd, Suite 123, Ponte Vedra, FL 32081-8401 Ph: () - | Lighthouse Chiropractic Llc 145 Hilden Rd, Suite 123, Ponte Vedra, FL 32081-8401 Ph: (904) 395-5371 |
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