1558085639 NPI number — ADJUST YOUR LIFE CHIROPRACTIC SARASOTA LLC

Table of content: MR. TRAVIS WHITTED (NPI 1417207655)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558085639 NPI number — ADJUST YOUR LIFE CHIROPRACTIC SARASOTA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADJUST YOUR LIFE CHIROPRACTIC SARASOTA LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558085639
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6410 SHOAL CREEK STREET CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRADENTON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34202-1711
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-302-1180
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8262 BEE RIDGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SARASOTA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34241-6311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-799-7207
Provider Business Practice Location Address Fax Number:
941-799-2077
Provider Enumeration Date:
10/03/2022

Additional Information

Authorized Official

Authorized Official Last Name:
FORD
Authorized Official First Name:
COLLEEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
941-799-7207

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com