Provider Demographics
NPI:1235394941
Name:THERAMED, LLC
Entity Type:Organization
Organization Name:THERAMED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:904-764-3434
Mailing Address - Street 1:9360 LEM TURNER RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-2200
Mailing Address - Country:US
Mailing Address - Phone:904-764-3434
Mailing Address - Fax:904-764-3211
Practice Address - Street 1:9360 LEM TURNER RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-2200
Practice Address - Country:US
Practice Address - Phone:904-764-3434
Practice Address - Fax:904-764-3211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8396111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty