Individual
JACKSON CHIO TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D., P.T.
Contact information
Practice address
6144 GAZEBO PARK PL S STE 101, JACKSONVILLE, FL 32257-1086
(904) 260-3011
(904) 260-3170
Mailing address
6144 GAZEBO PARK PL S STE 101, JACKSONVILLE, FL 32257-1086
(904) 260-3011
(904) 260-3170
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME71587
FL
225400000X
Rehabilitation Practitioner
ME0071587
FL
Other
Enumeration date
03/14/2007
Last updated
11/05/2023
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