Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CH0004041 | FL |
NPI | 1366453375 |
---|---|
Provider Name | Dr. Patrick Johnny Opachich |
First Address | Jacksonville, FL 32210-1804 |
Second Address | Jacksonville, FL 32210-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 26/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T55998 | (02) |