Provider Demographics
NPI:1366630139
Name:WESTCOAST SPINE CENTER SARASOTA PA
Entity Type:Organization
Organization Name:WESTCOAST SPINE CENTER SARASOTA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-362-2000
Mailing Address - Street 1:1217 S EAST AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2352
Mailing Address - Country:US
Mailing Address - Phone:941-362-2000
Mailing Address - Fax:941-362-9114
Practice Address - Street 1:1217 S EAST AVE STE 304
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2352
Practice Address - Country:US
Practice Address - Phone:941-362-2000
Practice Address - Fax:941-362-9114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005461111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty