Provider Demographics
NPI:1518237635
Name:SARABAY PAIN AND INJURY REHAB
Entity Type:Organization
Organization Name:SARABAY PAIN AND INJURY REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:IVEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-538-6882
Mailing Address - Street 1:6320 15TH ST E
Mailing Address - Street 2:SUITE 7
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-3250
Mailing Address - Country:US
Mailing Address - Phone:941-538-6882
Mailing Address - Fax:941-538-6334
Practice Address - Street 1:6320 15TH ST E
Practice Address - Street 2:SUITE 7
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-3250
Practice Address - Country:US
Practice Address - Phone:941-538-6882
Practice Address - Fax:941-538-6334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty