| Advanced Spine & Joint Medical Center Llc | |
|
208 Ne 3rd Ave Okeechobee FL 34972-2961 | |
| (863) 763-4320 | |
| Not Available |
| Full Name | Advanced Spine & Joint Medical Center Llc |
|---|---|
| Speciality | General Practice |
| Location | 208 Ne 3rd Ave, Okeechobee, Florida |
| Authorized Official Name and Position | Jennifer Cook (OWNER) |
| Authorized Official Contact | 8637634320 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Spine & Joint Medical Center Llc 208 Ne 3rd Ave Okeechobee FL 34972-2961 Ph: () - | Advanced Spine & Joint Medical Center Llc 208 Ne 3rd Ave Okeechobee FL 34972-2961 Ph: (863) 763-4320 |
| NPI Number | 1972146868 |
|---|---|
| Provider Enumeration Date | 10/23/2019 |
| Last Update Date | 08/04/2020 |
| Medicare PECOS PAC ID | 6406282482 |
|---|---|
| Medicare Enrollment ID | O20200211001696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972146868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jennifer Ann Cook |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1881973477 PECOS PAC ID: 7416129002 Enrollment ID: I20111003000682 |
| Provider Name | Craig C Jochum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487780433 PECOS PAC ID: 0446335715 Enrollment ID: I20200211002668 |
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