Organization
FIRST COAST SPINE & REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENEANE WAKULA (OFFICE MANAGER)
(772) 546-9591
Entity
Organization
Contact information
Practice address
100 WHETSTONE PL STE 310, ST AUGUSTINE, FL 32086-5775
(904) 516-8600
Mailing address
8929 SE BRIDGE RD, HOBE SOUND, FL 33455-5312
(772) 546-9591
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
01/11/2018
Last updated
01/11/2018
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