Provider Demographics
NPI:1972626851
Name:ACCIDENT CARE & WELLNESS CHIROPRACTIC CLINICS
Entity Type:Organization
Organization Name:ACCIDENT CARE & WELLNESS CHIROPRACTIC CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
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:904-786-2781
Mailing Address - Street 1:5913 NORMANDY BLVD
Mailing Address - Street 2:SUITE #13
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-6298
Mailing Address - Country:US
Mailing Address - Phone:904-786-2781
Mailing Address - Fax:904-786-9954
Practice Address - Street 1:5913 NORMANDY BLVD
Practice Address - Street 2:SUITE #13
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-6298
Practice Address - Country:US
Practice Address - Phone:904-786-2781
Practice Address - Fax:904-786-9954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-07
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8396111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty