Individual
RYAN CHANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2142 HERSCHEL ST, JACKSONVILLE, FL 32204-3820
(904) 477-4750
Mailing address
2142 HERSCHEL ST, JACKSONVILLE, FL 32204-3820
(904) 477-4750
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
678367868
—
FL
05
—
678367896
—
FL
Enumeration date
02/01/2013
Last updated
02/01/2013
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