Provider Demographics
NPI:1265636732
Name:SATTO, PETER J (DC)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:J
Last Name:SATTO
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 1:104 SAN LUCIA DR
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-5421
Mailing Address - Country:US
Mailing Address - Phone:386-848-2838
Mailing Address - Fax:
Practice Address - Street 1:770 MONROE RD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-8877
Practice Address - Country:US
Practice Address - Phone:386-848-2838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X52041Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID