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Organization
SPORT & SPINAL REHAB
Active
Organization
SPORT & SPINAL REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAYSEN TORREY SUDNYKOVYCH D.C. (OWNER)
(561) 629-3501
Entity
Organization
Contact information
Practice address
275 TONEY PENNA DR STE 12, JUPITER, FL 33458-5752
(561) 746-4242
(561) 746-7405
Mailing address
275 TONEY PENNA DR STE 12, JUPITER, FL 33458-5752
(561) 746-4242
(561) 746-7405
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
07/28/2010
Last updated
07/28/2010
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