Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CH9014 | FL |
NPI | 1295848380 |
---|---|
Provider Name | Dr. Jeffrey David Lipp |
First Address | Jacksonville, FL 32216-8070 |
Second Address | Jacksonville, FL 32216-8070 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 08/10/2015 |