Provider Demographics
NPI:1245703776
Name:ONECARE SPINE AND INJURY CENTERS LLC
Entity type:Organization
Organization Name:ONECARE SPINE AND INJURY CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:JACOBSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:386-226-0011
Mailing Address - Street 1:755 WESTMORELAND RD
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-1626
Mailing Address - Country:US
Mailing Address - Phone:386-226-0011
Mailing Address - Fax:386-226-0013
Practice Address - Street 1:755 WESTMORELAND RD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-1626
Practice Address - Country:US
Practice Address - Phone:386-226-0011
Practice Address - Fax:386-226-0013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-08
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty