Provider Demographics
NPI:1548751431
Name:ON POINT CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ON POINT CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:COGO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:386-603-8001
Mailing Address - Street 1:22A PLATEAU LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-7439
Mailing Address - Country:US
Mailing Address - Phone:386-986-8013
Mailing Address - Fax:
Practice Address - Street 1:9 PALM HARBOR VILLAGE WAY STE D
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-8278
Practice Address - Country:US
Practice Address - Phone:386-603-8001
Practice Address - Fax:386-603-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12011111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty