New Patient Information

Your first visit to Cobblestone Spine and Joint Institute runs 45 to 60 minutes. It is an evaluation appointment, not a treatment appointment. Dr. Dean Mammales, DC performs a full orthopedic and neurological examination before any hands-on care begins. You will leave the first visit knowing your diagnosis and your recommended treatment plan.

Cobblestone has operated on Okeechobee Blvd at SR-7 in Royal Palm Beach since 2006. The clinical model here is diagnosis-first. We do not adjust every new patient on the first visit because not every new patient presentation warrants the same intervention. Some conditions require imaging before treatment begins. Others require ruling out referral sources before starting any local care.

What Happens at Your First Visit

The appointment begins with a health history review. Bring any imaging you have, including X-rays, MRIs, or CT scans, even if they were taken elsewhere. Bring your insurance card, a list of current medications, and the accident report if your visit is related to an auto or work injury.

Dr. Mammales conducts the orthopedic and neurological examination. This includes range of motion assessment, orthopedic provocation tests specific to your presenting complaint, neurological screening for nerve root involvement, and palpatory examination of the spine and surrounding musculature. For presentations with a suspected disc or nerve root component, X-rays are taken in-house. You do not need to schedule imaging separately.

After the examination, Dr. Mammales explains what he found, what it means, and what your options are. This is a direct conversation. If your condition is outside the scope of what chiropractic and the services at Cobblestone can address, he will tell you that and refer you to the appropriate provider. We do not recommend care that is not appropriate for your case.

Same Doctor Every Visit

Dr. Mammales sees every new patient personally and continues to see his patients at every follow-up. You are not handed off to a different provider after the first visit. You are not adjusted by a chiropractic assistant. The same doctor who evaluated you on day one evaluates your progress at every subsequent appointment. This matters for continuity and for the accuracy of clinical decisions as your care progresses.

The clinic has operated this way since 2006. It is not a walk-in model. It is not a volume practice. Appointments are scheduled, and patients are seen at their appointment time.

Regenerative and Medical Services

If your first visit reveals a condition where regenerative medicine may be appropriate, such as significant joint degeneration, tendon damage, or a condition where PRP or stem cell therapy would be discussed, a separate consultation with Yuleisy Coto, MSN, APRN, FNP-C (FL APRN License No. APRN11009024) can be scheduled. Yuleisy handles all PRP injections, stem cell procedures, hormone replacement therapy, and peptide protocols at Cobblestone. The two practitioners work together on the same patient when the clinical situation benefits from both the mechanical and biological approach simultaneously.

Insurance and Payment

Cobblestone accepts most major insurance plans for chiropractic services. Florida PIP coverage is accepted for auto accident patients. Workers' compensation cases are evaluated individually. If you are unsure whether your specific plan is accepted, call the office before your appointment. Self-pay rates are available and are discussed directly at the time of scheduling. See the insurance page for a more detailed overview of coverage.

Free Parking, Walk-In Hours Not Required

Free parking is directly in front of the clinic at 10233 Okeechobee Blvd., Suite B-6. The building is the strip center at the Okeechobee and SR-7 intersection. Appointments are scheduled Monday, Tuesday, Wednesday, and Friday. Saturday morning appointments are available. Thursday is closed.