Jacksonville Orthopaedic Institute INC
Physical Therapist in Jacksonville, FL. Organization (NPI-2).
NPI number1124176540
StatusActive
Last updated in NPPESJan 8, 2019
Details
- NPI
- 1124176540
- Entity type
- Organization (NPI-2)
- Legal business name
- Jacksonville Orthopaedic Institute INC
- Organization subpart
- No
- Enumeration date
- Jan 8, 2007
- Last updated
- Jan 8, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | FL | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AL351 | FL | |
| 225X00000X | Occupational Therapist | – | FL |
Other names
- Jacksonville Orthopaedic Institute Rehabilitation (Other Name)
Practice location
1325 San Marco BlvdSuite 102
Jacksonville, FL 32207-8568
Phone 904-557-9021 · Fax 904-557-9022
Mailing address
Po Box 117345Atlanta, GA 30368-7345
Phone 904-346-3465 · Fax 904-858-6489
Authorized official
Timothy Edwin Wall
Administrator
9048587045
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