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Organization
REVOLUTION CHIROPRACTIC LLC
Active
Organization
REVOLUTION CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAUREN ASHLEY COST D.C. (OWNER)
(904) 716-1098
Entity
Organization
Contact information
Practice address
14866 OLD ST AUGUSTINE ROAD, SUITE 113, JACKSONVILLE, FL 32258
(904) 716-1098
Mailing address
313 SUMMER SPRINGS CT, JACKSONVILLE, FL 32225-4186
(904) 716-1098
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
11821
FL
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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