Organization
COLUMBIA COUNTY CHIROPRACTIC CENTER, LLC
Active
Other names
Darrel Thomas Mathis
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARREL THOMAS MATHIS D.C. (OWNER/PHYSICIAN)
(386) 752-4313
Entity
Organization
Contact information
Practice address
279 SW MAIN BLVD, LAKE CITY, FL 32025-7050
(386) 752-4313
(386) 752-8356
Mailing address
279 SW MAIN BLVD, LAKE CITY, FL 32025-7050
(386) 752-4313
(386) 752-8356
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
CH5141
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
050782200
—
FL
01
—
CL2214
RAILROAD MEDICARE GROUP #
FL
Enumeration date
07/18/2007
Last updated
03/24/2017
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