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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
TIMOTHY WALL (ADMINISTRATOR)
(904) 858-7045
Entity
Organization
Contact information
Practice address
12276 SAN JOSE BLVD, SUITE 716 & 717, JACKSONVILLE, FL 32223-8628
(904) 288-9604
(904) 288-9643
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
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
09/30/2008
Last updated
01/08/2019
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