Organization
ACTIVE HEALTH CARE, PA
Active
Other names
Active Chiropractic Medicine and Soft Tissue, P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY D LIPP DC, DACBSP (OWNER)
(904) 296-0202
Entity
Organization
Contact information
Practice address
6500 BOWDEN RD, 200, JACKSONVILLE, FL 32216-8070
(904) 296-0202
Mailing address
6500 BOWDEN RD, 200, JACKSONVILLE, FL 32216-8070
(904) 296-0202
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HT208A
MEDICARE PTAN
—
Enumeration date
05/15/2013
Last updated
10/08/2015
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