Organization
FULL BLOOM CHIROPRACTIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN GUTIERREZ (PRESIDENT)
(904) 481-8552
Entity
Organization
Contact information
Practice address
115 LAND GRANT ST STE 3, ST AUGUSTINE, FL 32092-3845
(904) 481-8552
Mailing address
115 LAND GRANT ST STE 3, ST AUGUSTINE, FL 32092-3845
(904) 481-8552
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1696
NM
Other
Enumeration date
02/23/2009
Last updated
09/08/2025
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