ADVANCED CHIROPRACTIC NUTRITION CENTER, P.A.
Chiropractic at 3 St, Jacksonville, FL

License number
Florida MM13448
Category
Chiropractic
Type
Chiropractor
Owner
Name: DR. THOMAS A. KISKA D.C., D.A.C.B.N.
Title: PRESIDENT
Phone: (904) 249-5999
Address
Address
440 3Rd St SUITE A, Jacksonville, FL 32266
National Provider ID: 1629139159
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ADVANCED CHIROPRACTIC NUTRITION CENTER, PA

Jacksonville, FL

Status:
Inactive
Inactive reason:
Name Change Amendment
Registration:
Jul 27, 1995
Inactive since:
Jun 6, 2002
Addresses:
440-A 3 St SUITE A, Neptune Beach, FL 32266 (Physical)
440 3 St, Jacksonville, FL 32266
440A 3 St, Jacksonville, FL 32266
State ID:
P95000058309
Business type:
Florida Profit Corporation
President, Directors:
Susan Ld.c. Shepler (Director, President), 440-A 3 St, Neptune Beach, FL 32266 (Physical),Thomas A. Kiska President, Director, inactive
Agent:
Susan Shepler,440-A 3 St, Neptune Beach, FL 32266 (Physical)
EIN:
59-3328684

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