Healthcare Provider Details

I. General information

NPI: 1457536237
Provider Name (Legal Business Name): MOSCOW CHIROPRACTIC LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2007
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3277 FRUITVILLE RD UNIT A-2
SARASOTA FL
34237-6410
US

IV. Provider business mailing address

3277 FRUITVILLE RD UNIT A-2
SARASOTA FL
34237-6410
US

V. Phone/Fax

Practice location:
  • Phone: 941-954-3700
  • Fax: 941-296-8202
Mailing address:
  • Phone: 941-954-3700
  • Fax: 941-296-8202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCH8809
License Number StateFL

VIII. Authorized Official

Name: LOUISA CHENG MOSCOW
Title or Position: OFFICE MANAGER
Credential:
Phone: 941-954-3700