ALL INJURY & DIAGNOSTIC CLINIC LLC (NPI# 1932672540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932672540 |
| Entity Type | Organization |
| Organization Name | ALL INJURY & DIAGNOSTIC CLINIC LLC |
| Practice Address |
125 Mason Ave Ste A Daytona Beach FL 32117-5017 |
| Practice Telephone | 3862520658 |
| Practice Fax Number | 3863130304 |
| Mailing Telephone | 3862520658 |
| Mailing Fax Number | 3863130304 |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2019-01-07 |
| Authorized Official Name | DR. JOHNATHAN LIVINGSTON WAGNER (OWNER) |
| Authorized Official Telephone | 3862902324 |
| Authorized Official Credential | BS,DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 247100000X | Radiologic Technologist | Technologists, Technicians & Other Technical Service Providers | ||
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | NPI TYPE 1 | 1881628220 | 01 |
| Street Address |
125 MASON AVE STE A |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117-5017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350409 | Erin Selfridge | Pharmacist | 1500 Beville Rd #300, Daytona Beach, FL 32117 | 2019-08-02 |
| 1881185494 | Wellspring Health, LLC | Chiropractor | 701 Ridgewood Ave, Holly Hills, FL 32117 | 2018-05-21 |
| 1780172791 | L & L Db, LLC | Clinic/Center | 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 | 2018-04-25 |
| 1154837789 | Brittany Nikolow | Nurse Practitioner | 1717 N. Clyde Morris, Daytona Beach, FL 32117 | 2017-12-19 |
| 1205356946 | Alejandro Andre Pabon Rodriguez | Nurse Anesthetist, Certified Registered | Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 | 2017-06-23 |
| 1316492135 | Ann Van Herck | Physical Therapist | 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 | 2016-08-22 |
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1053719559 | Alicia Graham | Case Manager/Care Coordinator | 1570 Megan Bay Circle, Holly Hill, FL 32117 | 2014-12-15 |
| 1578974440 | Halifax Senior Care Inc | Clinic/Center | 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 | 2014-05-14 |
| 1013345883 | Kist Alf, Inc | Assisted Living Facility | 1516 Carmen Avenue, Daytona Beach, FL 32117 | 2013-10-14 |
| Find all providers in zip 32117 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669946638 | Ryan Adam Revels | Chiropractor | 433 Silver Beach Ave Ste 101, Daytona Beach, FL 32118-7104 | 2019-01-14 |
| 1922594472 | Josh Clark | Chiropractor | 1620 S Clyde Morris Blvd, Daytona Beach, FL 32119-9020 | 2018-07-09 |
| 1447706163 | Christopher Ali Amirzadeh | Chiropractor | 152 W Sandalwood Ct, Daytona Beach, FL 32119-1465 | 2016-09-01 |
| 1427415421 | Lucy B Mckinniss | Chiropractor | 1620 S Clyde Morris Blvd Ste 200, Daytona Beach, FL 32119-9008 | 2016-01-21 |
| 1871968313 | Kristine Georgia Lamana | Chiropractor | 240 S. Palmetto Ave, Daytona Beach, FL 32114 | 2015-12-09 |
| 1821484387 | Taylor Hoeffert | Chiropractor | 211 E International Speedway Blvd, Suite 202, Daytona Beach, FL 32118-4689 | 2015-04-11 |
| 1235556218 | John Nelson | Chiropractor | 115 S Palmetto Ave, Daytona Beach, FL 32114-4319 | 2014-03-27 |
| 1710300363 | Elizabeth Echevarria | Chiropractor | 1200 Beville Rd, Daytona Beach, FL 32114 | 2014-01-31 |
| 1164852760 | Jaime Perez Melendez | Chiropractor | 600 N Clyde Morris Blvd, Suite 2, Daytona Beach, FL 32114-2322 | 2013-11-18 |
| 1346500501 | Amy Lynn Wolf | Chiropractor | 206 S Beach St, Daytona Beach, FL 32114-4404 | 2012-05-22 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32117 |
Please comment or provide details below to improve the information on ALL INJURY & DIAGNOSTIC CLINIC LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.