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