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Organization
EMERALD COAST CHIROPRACTIC INC
Active
Organization
EMERALD COAST CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEAN CALLAHAN JACKS DC (PRESIDENT)
(850) 678-8048
Entity
Organization
Contact information
Practice address
705 JOHN SIMS PKWY W, NICEVILLE, FL 32578-1878
(850) 678-8048
(850) 678-2629
Mailing address
705 JOHN SIMS PKWY W, NICEVILLE, FL 32578-1878
(850) 678-8048
(850) 678-2629
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH0007070
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55426
BLUE CROSS BLUE SHIELD
FL
01
—
DA1478
RAILRAOD MEDICARE
FL
Enumeration date
07/14/2006
Last updated
02/05/2013
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