| Fl Neuro Pain And Spine Center, .p.a. | |
|
2614 Jenks Ave, Panama City, FL 32405-4311 | |
| (850) 215-3000 | |
| (850) 215-3150 |
| Full Name | Fl Neuro Pain And Spine Center, .p.a. |
|---|---|
| Type | Facility |
| Speciality | Clinic/center - Health Service |
| Location | 2614 Jenks Ave, Panama City, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194034397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 261QH0100X | Clinic/center - Health Service | CH 10072 (Florida) | Primary |
| Provider Name | John J O Connell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720028186 PECOS PAC ID: 7113986696 Enrollment ID: I20041008001185 |
| Provider Name | Wesley J Johnson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1902112170 PECOS PAC ID: 2466614177 Enrollment ID: I20120425000495 |
| Provider Name | Bryan L Pruess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679071799 PECOS PAC ID: 6002177078 Enrollment ID: I20180308000840 |
| Provider Name | Melinda Luther |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942638341 PECOS PAC ID: 6608006911 Enrollment ID: I20181106002221 |
| Provider Name | Cory A Imhof |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1215259320 PECOS PAC ID: 0648424895 Enrollment ID: I20211201002962 |
| Provider Name | Nicole Marie Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710670013 PECOS PAC ID: 6800235623 Enrollment ID: I20240412002421 |
| Provider Name | Liza Danielle Ingram |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295856730 PECOS PAC ID: 7416294624 Enrollment ID: I20241007001492 |
| Mailing Address | Practice Location Address |
|---|---|
| Fl Neuro Pain And Spine Center, .p.a. 2614 Jenks Ave, Panama City, FL 32405-4311 Ph: (850) 215-3000 | Fl Neuro Pain And Spine Center, .p.a. 2614 Jenks Ave, Panama City, FL 32405-4311 Ph: (850) 215-3000 |