Provider Demographics
NPI:1992009005
Name:FRITZ, JON PAUL (DC)
Entity type:Individual
Prefix:MR
First Name:JON PAUL
Middle Name:
Last Name:FRITZ
Suffix:
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 1:1605 COUNTY ROAD 220
Mailing Address - Street 2:STE165
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-4908
Mailing Address - Country:US
Mailing Address - Phone:904-425-9060
Mailing Address - Fax:904-425-9061
Practice Address - Street 1:1605 COUNTY ROAD 220
Practice Address - Street 2:SUITE 165
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-4908
Practice Address - Country:US
Practice Address - Phone:904-425-9060
Practice Address - Fax:904-425-9061
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-04
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor