Provider Demographics
NPI:1033568779
Name:GOLD STANDARD CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:GOLD STANDARD CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GOLDAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-363-1897
Mailing Address - Street 1:625 N WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-4241
Mailing Address - Country:US
Mailing Address - Phone:941-363-1897
Mailing Address - Fax:
Practice Address - Street 1:625 N WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-4241
Practice Address - Country:US
Practice Address - Phone:941-363-1897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 11761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty