Organization
FL NEURO PAIN AND SPINE CENTER, .P.A.
Active
Parent organization
FL NEURO PAIN AND SPINE CENTER, .P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
FL NEURO PAIN AND SPINE CENTER, .P.A.
Authorized official
WESLEY JOHNSON DC (OWNER)
(850) 215-3000
Entity
Organization
Contact information
Practice address
2614 JENKS AVE, PANAMA CITY, FL 32405
(850) 215-3000
Mailing address
2614 JENKS AVE, PANAMA CITY, FL 32405-4311
(850) 215-3000
(850) 215-3150
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006J1
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/16/2019
Last updated
12/12/2023
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