Basic Information
| Provider Information | |||||||||
| NPI: | 1366092488 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THERAPYWORKS OF JACKSONVILLE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1819 HENDRICKS AVE | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322073303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043485511 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7855 ARGYLE FOREST BLVD STE 703 | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322447705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043485511 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2019 | ||||||||
| LastUpdateDate: | 09/19/2019 | ||||||||
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| AuthorizedOfficialLastName: | LEHMAN | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | ROBERT | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9043485511 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |
No ID Information.