# JAD THERAPY LLC

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

## Provider details

- **NPI number:** 1235239625
- **Authorized official:** JAMES ARTHUR DERRENBACKER JR. D.O. (CEO)
- **Authorized official phone:** (352) 563-2407

## Contact information

- **Practice address:** 1669 SE HIGHWAY 19, CRYSTAL RIVER, FL 34429
- **Practice address phone:** (352) 563-2407
- **Practice address fax:** (352) 563-2807
- **Mailing address:** P.O. BOX 2154, CRYSTAL RIVER, FL 34423
- **Mailing address phone:** (352) 563-2407
- **Mailing address fax:** (352) 563-2807

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | OS 0006090 | FL | Yes |

## Other

- **Enumeration date:** 09/25/2006
- **Last updated:** 08/22/2020