Provider Demographics
NPI:1669263430
Name:GREENFIELD, JACOB M (DC)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:M
Last Name:GREENFIELD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 SCENIC HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-6617
Mailing Address - Country:US
Mailing Address - Phone:850-473-5555
Mailing Address - Fax:850-332-7647
Practice Address - Street 1:1117 N PALAFOX ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-2607
Practice Address - Country:US
Practice Address - Phone:850-433-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH15193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor