Organization
FIRST STATE SPINAL REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENEANE MARIE WAKULA (OFFICE MANAGER)
(772) 546-9591
Entity
Organization
Contact information
Practice address
2500 W 4TH ST STE 4, WILMINGTON, DE 19805-3352
(772) 546-9591
Mailing address
9044 SE BRIDGE RD, HOBE SOUND, FL 33455-5313
(772) 546-9591
(772) 546-9535
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
09/25/2019
Last updated
09/25/2019
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