Provider Demographics
NPI:1093873960
Name:GULSBY, TIMOTHY RAY (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:RAY
Last Name:GULSBY
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 1:205 MONTGOMERY AVE
Mailing Address - Street 2:2
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-1500
Mailing Address - Country:US
Mailing Address - Phone:941-351-0004
Mailing Address - Fax:941-351-6264
Practice Address - Street 1:205 MONTGOMERY AVE
Practice Address - Street 2:2
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-1500
Practice Address - Country:US
Practice Address - Phone:941-351-0004
Practice Address - Fax:941-351-6264
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7325111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor