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Contact Information

REVOLUTION CHIROPRACTIC LLC
14866 OLD ST AUGUSTINE ROAD
SUITE 113
JACKSONVILLE, FL32258
 Phone: 904-716-1098
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for REVOLUTION CHIROPRACTIC LLC

NPI # 1124576566
LBN Legal business name REVOLUTION CHIROPRACTIC LLC
Authorized official LAUREN COST - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/14/2016
Last updated 09/14/2016 - About 10 years ago
Identifiers
FL License # 11821
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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