| NPI | 1457797557 |
|---|---|
| Former Legal Business Name | ACTIVE CHIROPRACTIC MEDICINE AND SOFT TISSUE, P.A. |
| Entity Type | Organization |
| Authorized Contact | JEFFREY D LIPP Owner 904-296-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2015-10-08 |