Provider Demographics
NPI:1265663975
Name:VANSANT, DARCIE M (DC)
Entity Type:Individual
Prefix:
First Name:DARCIE
Middle Name:M
Last Name:VANSANT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 ATLANTIC BLVD
Mailing Address - Street 2:STE 226
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-2920
Mailing Address - Country:US
Mailing Address - Phone:701-866-2413
Mailing Address - Fax:
Practice Address - Street 1:11900 ATLANTIC BLVD
Practice Address - Street 2:STE 226
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-2920
Practice Address - Country:US
Practice Address - Phone:904-338-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor