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General NPI Number Information
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NPI Number | 1255526109
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Entity Type | Organization
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Legal Business Name | SOROKA STARBUCK PA DBA FAMILY CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 35 CLAYTON LN SUITE A
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-5781
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Country | US
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Telephone | 850-231-0211
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Fax | 850-231-6006
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Provider Business Mailing Address
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Address Line | 35 CLAYTON LN SUITE A
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-5781
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Country | US
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Telephone | 850-231-0211
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Fax | 850-231-6006
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | DR. BRIAN KEITH SOROKA
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Credential | D.C.
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Telephone | 850-231-2011
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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 | CH5044
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License Number State | FL
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