HODGES BEACH PHYSICAL REHABILITATION PLLC
Chiropractic at Beach Blvd, Jacksonville, FL

License number
Florida CH8853
Category
Chiropractic
Type
Chiropractor
Owner
Name: RICHARD RAY BLOOM SR. D.C.
Title: OWNER/CHIROPRACTOR
Phone: (904) 223-3330
Address
Address
13947 Beach Blvd STE 202, Jacksonville, FL 32224
National Provider ID: 1528396199
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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HODGES BEACH PHYSICAL REHABILITATION PLLC

Jacksonville, FL

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Sep 17, 2009
Inactive since:
Sep 28, 2012
Addresses:
13947 Bch Blvd 202, Jacksonville, FL 32224 (Physical)
13947 Bch Blvd, Jacksonville, FL 32224
State ID:
L09000090037
Business type:
Florida Limited Liability Company
Managing Member:
Richard Rsr Bloom Managing Member, inactive, 13947 Bch Blvd, Jacksonville, FL 32224 (Physical)
Agent:
Richard Bloom,13947 Bch Blvd SUITE 202, Jacksonville, FL 32224 (Physical)
EIN:
270955933

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