Provider Demographics
NPI:1447595889
Name:RIVER HILLS CHIROPRACTIC CLINIC INC
Entity type:Organization
Organization Name:RIVER HILLS CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:DUKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:904-721-5464
Mailing Address - Street 1:1807 UNIVERSITY BLVD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-8930
Mailing Address - Country:US
Mailing Address - Phone:904-721-5464
Mailing Address - Fax:904-721-0835
Practice Address - Street 1:1807 UNIVERSITY BLVD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8930
Practice Address - Country:US
Practice Address - Phone:904-721-5464
Practice Address - Fax:904-721-5464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5891111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty