| Disc Centers Of America - Ponte Vedra | |
|
1400 Marsh Landing Pkwy Ste 107, Jacksonville Beach, FL 32250-2492 | |
| (904) 644-3472 | |
| Not Available |
| Full Name | Disc Centers Of America - Ponte Vedra |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1400 Marsh Landing Pkwy Ste 107, Jacksonville Beach, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447746219 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 012784 (New York) | Primary |
| Provider Name | Matthew L Glass |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1528310877 PECOS PAC ID: 5597904607 Enrollment ID: I20231208000029 |
| Mailing Address | Practice Location Address |
|---|---|
| Disc Centers Of America - Ponte Vedra 1400 Marsh Landing Pkwy Ste 107, Jacksonville Beach, FL 32250-2492 Ph: (904) 644-3472 | Disc Centers Of America - Ponte Vedra 1400 Marsh Landing Pkwy Ste 107, Jacksonville Beach, FL 32250-2492 Ph: (904) 644-3472 |
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