Provider Demographics
NPI:1588621684
Name:SOUTHER, JOHN B (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:B
Last Name:SOUTHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:1514 S ALEXANDER ST
Mailing Address - Street 2:106
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-8415
Mailing Address - Country:US
Mailing Address - Phone:813-717-7553
Mailing Address - Fax:813-717-7593
Practice Address - Street 1:1514 S ALEXANDER ST
Practice Address - Street 2:106
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-8415
Practice Address - Country:US
Practice Address - Phone:813-717-7553
Practice Address - Fax:813-717-7593
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLCH8722111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV08602Medicare UPIN