| Gordon Family Chiropractic Inc | |
|
228 Ponte Vedra Park Dr, Suite 800, Ponte Vedra, FL 32082-6613 | |
| (904) 418-3937 | |
| Not Available |
| Full Name | Gordon Family Chiropractic Inc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 228 Ponte Vedra Park Dr, Ponte Vedra, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508304783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CH9576 (Florida) | Primary |
| Provider Name | Wayne O Gordon |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1003952573 PECOS PAC ID: 8820192412 Enrollment ID: I20170322001503 |
| Mailing Address | Practice Location Address |
|---|---|
| Gordon Family Chiropractic Inc 228 Ponte Vedra Park Dr, Suite 800, Ponte Vedra, FL 32082-6613 Ph: (904) 418-3937 | Gordon Family Chiropractic Inc 228 Ponte Vedra Park Dr, Suite 800, Ponte Vedra, FL 32082-6613 Ph: (904) 418-3937 |
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