Provider Demographics
NPI:1447898457
Name:HYPERBARIC THERAPY OF JACKSONVILLE
Entity type:Organization
Organization Name:HYPERBARIC THERAPY OF JACKSONVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DODSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-407-4268
Mailing Address - Street 1:6750 AVERY MUIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1202
Mailing Address - Country:US
Mailing Address - Phone:614-733-4268
Mailing Address - Fax:
Practice Address - Street 1:11701 SAN JOSE BLVD STE 108
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-0756
Practice Address - Country:US
Practice Address - Phone:407-984-7757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center