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Organization
JACKSONVILLE ORTHOPAEDIC INSTITUTE INC
Active
Organization
JACKSONVILLE ORTHOPAEDIC INSTITUTE INC
Active
Other names
Jacksonville Orthopaedic Institute Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY EDWIN WALL MS, ATC (ADMINISTRATOR)
(904) 858-7045
Entity
Organization
Contact information
Practice address
5393 ROOSEVELT BLVD, SUITE 17, JACKSONVILLE, FL 32210-8448
(904) 389-8570
(904) 389-8599
Mailing address
PO BOX 117345, ATLANTA, GA 30368-7345
(904) 346-3465
(904) 858-6489
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2255A2300X
Athletic Trainer
AL351
FL
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
01/08/2007
Last updated
01/08/2019
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