| NPI | 1619411485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYDE GRAY Co Owner 904-775-8949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11739) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH11736) |
| 111N00000X Chiropractor (Licence: FL CH12047) | |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2018-01-08 |