Jacksonville Orthopaedic Institute INC
Physical Therapist in Jacksonville Beach, FL. Organization (NPI-2).
NPI number1902954332
StatusActive
Last updated in NPPESJan 24, 2019
Details
- NPI
- 1902954332
- Entity type
- Organization (NPI-2)
- Legal business name
- Jacksonville Orthopaedic Institute INC
- Organization subpart
- No
- Enumeration date
- Jan 8, 2007
- Last updated
- Jan 24, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AL351 | FL | |
| 225X00000X | Occupational Therapist | – | – |
Other names
- Jacksonville Orthopaedic Institute Rehabilitation (Other Name)
Practice location
1577 Roberts DrSuite 320
Jacksonville Beach, FL 32250-3264
Phone 904-247-3324 · Fax 904-247-3926
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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