Individual
DR. J EDWARD HARTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1740 TREE BLVD, STE 115, SAINT AUGUSTINE, FL 32084-5720
(904) 679-3233
(904) 679-3599
Mailing address
1740 TREE BLVD, STE 115, SAINT AUGUSTINE, FL 32084-5720
(904) 679-3233
(904) 679-3599
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
Primary
6696
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
380921800
—
FL
01
—
593375448
TAX ID
FL
Enumeration date
11/29/2006
Last updated
02/28/2017
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