Provider Demographics
NPI:1215199617
Name:MANATEE MEDICAL MASSAGE & CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:MANATEE MEDICAL MASSAGE & CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SUTPHIN
Authorized Official - Suffix:SR
Authorized Official - Credentials:DC
Authorized Official - Phone:941-723-1908
Mailing Address - Street 1:2823 US HIGHWAY 301 N
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ELLENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34222-2084
Mailing Address - Country:US
Mailing Address - Phone:941-723-1908
Mailing Address - Fax:941-723-1303
Practice Address - Street 1:2823 US HIGHWAY 301 N
Practice Address - Street 2:SUITE 3
Practice Address - City:ELLENTON
Practice Address - State:FL
Practice Address - Zip Code:34222-2084
Practice Address - Country:US
Practice Address - Phone:941-723-1908
Practice Address - Fax:941-723-1303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty