# CHESAPEAKE HYPERBARIC LC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205159423
- **Authorized official:** DR. MICHELLE RENEE REILLO PH.D., R.N. (DIRECTOR)
- **Authorized official phone:** (904) 271-1053

## Contact information

- **Practice address:** 129 SEAGROVE MAIN STREET, UNIT 202, ST. AUGUSTINE, FL 32080
- **Practice address phone:** (804) 296-4094
- **Mailing address:** 9562 DEERECO ROAD, UTHERVILLE, MD 21093
- **Mailing address phone:** (904) 271-1053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | R080304 | MD | Yes |

## Other

- **Enumeration date:** 03/02/2010
- **Last updated:** 03/02/2010