Provider Demographics
NPI:1811449119
Name:JUSTICE, ROCKY II (DC)
Entity type:Individual
Prefix:DR
First Name:ROCKY
Middle Name:
Last Name:JUSTICE
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 S VOLUSIA AVE STE B2
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-7625
Mailing Address - Country:US
Mailing Address - Phone:304-952-3161
Mailing Address - Fax:
Practice Address - Street 1:2425 S VOLUSIA AVE STE B2
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-7625
Practice Address - Country:US
Practice Address - Phone:304-952-3161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-04811111N00000X
FLCH11991111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor