Organization
JCC LLC
Active
Other names
Jacksonville Chiropractic Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL THOMAS WISE D.C. (DOCTOR/OWNER)
(410) 592-7300
Entity
Organization
Contact information
Practice address
14307 JARRETTSVILLE PIKE, PHOENIX, MD 21131-1763
(410) 592-7300
(410) 666-0348
Mailing address
PO BOX 38, 14307 JARRETTSVILLE PIKE, PHOENIX, MD 21131-0038
(410) 592-7300
(410) 666-0348
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
S01332
MD
Other
Enumeration date
02/15/2008
Last updated
02/15/2008
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