Provider Demographics
NPI: | 1558085639 |
---|---|
Name: | ADJUST YOUR LIFE CHIROPRACTIC SARASOTA LLC |
Entity Type: | Organization |
Organization Name: | ADJUST YOUR LIFE CHIROPRACTIC SARASOTA LLC |
Other - Org Name: | ADJUST YOUR LIFE CHIROPRACTIC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | COLLEEN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FORD |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DC |
Authorized Official - Phone: | 941-799-7207 |
Mailing Address - Street 1: | 6410 SHOAL CREEK STREET CIR |
Mailing Address - Street 2: | |
Mailing Address - City: | BRADENTON |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 34202-1711 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 941-302-1180 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 8262 BEE RIDGE RD |
Practice Address - Street 2: | |
Practice Address - City: | SARASOTA |
Practice Address - State: | FL |
Practice Address - Zip Code: | 34241-6311 |
Practice Address - Country: | US |
Practice Address - Phone: | 941-799-7207 |
Practice Address - Fax: | 941-799-2077 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-10-03 |
Last Update Date: | 2022-11-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor | Group - Single Specialty |