Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH11358 | FL |
NPI | 1003213778 |
---|---|
Provider Name | Dr. Jonathan Wojciechowski |
First Address | Jacksonville, FL 32226-2098 |
Second Address | Jacksonville, FL 32226-2098 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2014 |
Last Update Date | 25/11/2014 |