Organization
MONAHAN CHIROPRACTIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN M MONAHAN D.C. (OWNER)
(904) 923-0968
Entity
Organization
Contact information
Practice address
4022 BLANDING BLVD, JACKSONVILLE, FL 32210-5417
(904) 778-7963
(904) 779-1329
Mailing address
4022 BLANDING BLVD, JACKSONVILLE, FL 32210-5417
(904) 778-7963
(904) 779-1329
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
CH3212
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
88420
MEDICARE PROVIDER NUMBER
FL
Enumeration date
01/20/2012
Last updated
01/20/2012
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