Provider Demographics
NPI:1134360951
Name:CHIROSTANDARD, PLLC
Entity type:Organization
Organization Name:CHIROSTANDARD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-487-8118
Mailing Address - Street 1:5922 CATTLEMEN LN
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6204
Mailing Address - Country:US
Mailing Address - Phone:941-487-8118
Mailing Address - Fax:941-487-8121
Practice Address - Street 1:5922 CATTLEMEN LN
Practice Address - Street 2:SUITE 102
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6204
Practice Address - Country:US
Practice Address - Phone:941-487-8118
Practice Address - Fax:941-487-8121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9574111N00000X
FLPT21876225100000X
FLCH9569111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCF748AOtherMEDICARE PTAN