Provider Demographics
NPI:1518991603
Name:ARGYLE CHIROPRACTIC CENTER P A
Entity type:Organization
Organization Name:ARGYLE CHIROPRACTIC CENTER P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHERTELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:904-778-0968
Mailing Address - Street 1:PO BOX 65339
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-0006
Mailing Address - Country:US
Mailing Address - Phone:904-778-0968
Mailing Address - Fax:904-573-1821
Practice Address - Street 1:6251 ARGYLE FOREST BLVD
Practice Address - Street 2:UNIT 101
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-8924
Practice Address - Country:US
Practice Address - Phone:904-778-0968
Practice Address - Fax:904-573-1821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 0007619111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381197200Medicaid
FLU80941Medicare UPIN
FLE4313ZMedicare ID - Type Unspecified