Provider Demographics
NPI:1104072347
Name:SEXTON FAMILY CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:SEXTON FAMILY CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SEXTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:904-282-3917
Mailing Address - Street 1:2747 BLANDING BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-5652
Mailing Address - Country:US
Mailing Address - Phone:904-282-3917
Mailing Address - Fax:904-282-3192
Practice Address - Street 1:2747 BLANDING BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-5652
Practice Address - Country:US
Practice Address - Phone:904-282-3917
Practice Address - Fax:904-282-3192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9303261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty