| NPI | 1548410756 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JONATHAN RAY WALKER Clinic Director 904-616-1284  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 208VP0000X  (Licence: FL OS7403)  | 
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH9403)  | 
| Enumeration Date | 2008-09-24 | 
| Last Update Date | 2021-10-13 |