Provider Demographics
NPI:1073721494
Name:ADIO, INC
Entity Type:Organization
Organization Name:ADIO, INC
Other - Org Name:ANCIENT CITY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:ACCURSO
Authorized Official - Suffix:SR
Authorized Official - Credentials:DC
Authorized Official - Phone:305-667-1188
Mailing Address - Street 1:84 THEATRE DR STE 500
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-3131
Mailing Address - Country:US
Mailing Address - Phone:904-222-6440
Mailing Address - Fax:
Practice Address - Street 1:84 THEATRE DR STE 500
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-3131
Practice Address - Country:US
Practice Address - Phone:904-222-6440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 1503111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty