Ponte Vedra Chiropractic Medicine & Physical Therapy, Inc.
NPI #1073799870 in Ponte Vedra Beach, Florida
Provider Information
- NPI Number
- 1073799870
- Entity Type
- Organization
- Organization Name
- Ponte Vedra Chiropractic Medicine & Physical Therapy, Inc.
- Primary Specialty
- Chiropractor
- Enumeration Date
- Jan 11, 2008
- Last Updated
- Dec 2, 2016
Practice Location
- Address
- 240 PONTE VEDRA PARK DR
- Address 2
- SUITE 150
- State
- Florida
- ZIP Code
- 32082-6601
- Phone
- (904) 285-2243
Authorized Official
- Name
- DR. RICHARD G. PACKO, D.C.
- Title
- PRESIDENT
- Phone
- (904) 285-2243
Specialties & Taxonomy Codes
| Specialty |
|---|
| Chiropractor |
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