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General NPI Number Information
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NPI Number | 1023446911
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Entity Type | Organization
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Legal Business Name | ALLAN R SIDORSKY DCPA
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Dates
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Enumeration Date | 10/31/2013
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Last Update Date | 10/31/2013
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Provider Practice Location Address
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Address Line | 1151 BLACKWOOD AVE SUITE 110
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City | OCOEE
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State | FL
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Zip | 34761-4550
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Country | US
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Telephone | 407-205-8847
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Fax | 407-253-1470
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Provider Business Mailing Address
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Address Line | 339 BEACON POINTE DR
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City | OCOEE
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State | FL
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Zip | 34761-4414
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Country | US
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Telephone | 954-673-2820
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Fax | 407-253-1470
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALLAN ROBERT SIDORSKY
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Credential | D.C.
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Telephone | 954-673-2820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | FL
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