Provider Demographics
NPI:1447557459
Name:JENNIFER J CHIAVETTA-GRISANTI DC PROFESSIONAL ASSOCIATION
Entity Type:Organization
Organization Name:JENNIFER J CHIAVETTA-GRISANTI DC PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIVETTA-GRISANTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-954-3700
Mailing Address - Street 1:2920 UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2412
Mailing Address - Country:US
Mailing Address - Phone:941-724-1580
Mailing Address - Fax:941-923-3882
Practice Address - Street 1:2030 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-6108
Practice Address - Country:US
Practice Address - Phone:941-954-3700
Practice Address - Fax:941-923-3882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty