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Organization
INTERCOASTAL CHIROPRACTIC CLINIC PA
Active
Organization
INTERCOASTAL CHIROPRACTIC CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE TUCKER (BILLING MANAGER)
(904) 272-3440
Entity
Organization
Contact information
Practice address
14255 BEACH BLVD STE A, JACKSONVILLE, FL 32250-1545
(904) 223-1616
Mailing address
14255 BEACH BLVD STE A, JACKSONVILLE, FL 32250-1545
(904) 223-1616
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH0007521
FL
Other
Enumeration date
01/23/2008
Last updated
08/04/2010
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