Provider Demographics
NPI:1619145679
Name:STRATER, JOSEPH JAISON (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JAISON
Last Name:STRATER
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 1:1950 VIERA BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-6672
Mailing Address - Country:US
Mailing Address - Phone:321-425-4620
Mailing Address - Fax:321-425-4690
Practice Address - Street 1:1950 VIERA BLVD STE 106
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-6672
Practice Address - Country:US
Practice Address - Phone:321-425-4620
Practice Address - Fax:321-425-4690
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor