Organization
CRG34AH01 LLC
Active
Other names
Medicus Spine & Joint
Organization subpart
No
Provider details
NPI number
Authorized official
LOGAN MORRIS (MANAGER)
(904) 503-1065
Entity
Organization
Contact information
Practice address
4540 SOUTHSIDE BLVD STE 202, JACKSONVILLE, FL 32216-5488
(904) 503-1065
(904) 374-6075
Mailing address
4540 SOUTHSIDE BLVD STE 202, JACKSONVILLE, FL 32216-5488
(904) 503-1065
(904) 374-6075
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0801X
Orthopaedic Trauma Physician
—
—
2084P0301X
Brain Injury Medicine (Psychiatry & Neurology) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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