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 |