Individual
DR. CARL S JEROME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
68 BEAL PKWY SW, FORT WALTON BEACH, FL 32548-5331
(850) 362-6767
Mailing address
68 BEAL PKWY SW, FORT WALTON BEACH, FL 32548-5331
(850) 362-6767
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
009236
GA
111N00000X
Chiropractor
Primary
11507
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790297588
GROUP NPI
—
Enumeration date
06/12/2015
Last updated
02/14/2018
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