Provider Demographics
NPI:1285321109
Name:HEALTHSOURCE OF MILTON LLC
Entity type:Organization
Organization Name:HEALTHSOURCE OF MILTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:RABINOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-473-5555
Mailing Address - Street 1:1090 SCENIC HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-6617
Mailing Address - Country:US
Mailing Address - Phone:850-473-5555
Mailing Address - Fax:
Practice Address - Street 1:5838 DOGWOOD DR STE 208
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-3576
Practice Address - Country:US
Practice Address - Phone:850-473-5555
Practice Address - Fax:850-332-7647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty