Provider Demographics
NPI:1871244178
Name:BARTRAM CHIROPRACTIC INC
Entity Type:Organization
Organization Name:BARTRAM CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-501-8221
Mailing Address - Street 1:9785 CROSSHILL BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32222-5823
Mailing Address - Country:US
Mailing Address - Phone:904-268-9100
Mailing Address - Fax:904-268-9700
Practice Address - Street 1:13720 OLD SAINT AUGUSTINE RD STE 4
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-7415
Practice Address - Country:US
Practice Address - Phone:904-268-9100
Practice Address - Fax:904-268-9700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-18
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty