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Organization
JACKSONVILLE ORTHOPAEDIC INSTITUTE INC
Active
Organization
JACKSONVILLE ORTHOPAEDIC INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY WALL (ADMINISTRATOR)
(904) 858-7045
Entity
Organization
Contact information
Practice address
105 MURABELLA PKWY STE 6, ST AUGUSTINE, FL 32092-4540
(904) 224-2666
(904) 224-2667
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
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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