Provider Demographics
NPI:1609279900
Name:DURFEE, JUSTIN (DC)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:DURFEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7222 S TAMIAMI TRL
Mailing Address - Street 2:105
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-5567
Mailing Address - Country:US
Mailing Address - Phone:407-729-9846
Mailing Address - Fax:
Practice Address - Street 1:7222 S TAMIAMI TRL
Practice Address - Street 2:105
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-5567
Practice Address - Country:US
Practice Address - Phone:941-921-4884
Practice Address - Fax:941-921-4883
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor