Organization · NPI-2

Active Spine Care LLC

Chiropractor · Jacksonville, FL

NPI number1538677133
StatusActive
Last updated in NPPESJun 11, 2019

Details

NPI
1538677133
Entity type
Organization (NPI-2)
Legal business name
Active Spine Care LLC
Organization subpart
No
Enumeration date
Jan 17, 2018
Last updated
Jun 11, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X ChiropractorCH12210FLYes

Practice location

9310 Old Kings Rd S Ste 1102
Jacksonville, FL 32257-6196

Phone 904-802-4410

Mailing address

9310 Old Kings Rd S Ste 1102
Jacksonville, FL 32257-6196

Phone 904-802-4410

Authorized official

Trang N Nghiem
Mgr
9048024410

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