| St. Augustine Spine Center | |
|
1750 Tree Blvd Ste 8, St Augustine, FL 32084-5719 | |
| (904) 429-7750 | |
| (904) 429-7664 |
| Full Name | St. Augustine Spine Center |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1750 Tree Blvd Ste 8, St Augustine, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457630063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CH9751 (Florida) | Primary |
| Provider Name | Tyler Darl Albrecht |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1982937173 PECOS PAC ID: 9638341381 Enrollment ID: I20111003000048 |
| Mailing Address | Practice Location Address |
|---|---|
| St. Augustine Spine Center 1750 Tree Blvd Ste 8, St Augustine, FL 32084-5719 Ph: (904) 429-7750 | St. Augustine Spine Center 1750 Tree Blvd Ste 8, St Augustine, FL 32084-5719 Ph: (904) 429-7750 |
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