| |
3864 San Jose Park Dr, Jacksonville, FL 32217-4613 | |
(904) 737-8552 | |
(904) 737-8113 |
Full Name | |
---|---|
Type | Facility |
Speciality | Massage Therapist |
Location | 3864 San Jose Park Dr, Jacksonville, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871815951 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CH4435 (Florida) | Secondary |
171100000X | Acupuncturist | AP2591 (Florida) | Secondary |
225700000X | Massage Therapist | MA24586 (Florida) | Primary |
Mailing Address | Practice Location Address |
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3864 San Jose Park Dr, Jacksonville, FL 32217-4613 Ph: (904) 737-8552 | 3864 San Jose Park Dr, Jacksonville, FL 32217-4613 Ph: (904) 737-8552 |