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General NPI Number Information
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NPI Number | 1275838856
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Entity Type | Organization
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Legal Business Name | DEMAIO CHIROPRACTIC WELLNESS CENTER LLC
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Dates
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Enumeration Date | 01/13/2011
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Last Update Date | 01/13/2011
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Provider Practice Location Address
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Address Line | 7101 CURTISS AVE
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City | SARASOTA
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State | FL
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Zip | 34231-8012
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Country | US
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Telephone | 941-504-1792
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Fax |
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Provider Business Mailing Address
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Address Line | 4002 CROCKERS LAKE BLVD UNIT 124
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City | SARASOTA
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State | FL
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Zip | 34238-5502
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Country | US
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Telephone | 941-504-1792
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. JUSTINE WANDA DEMAIO
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Credential | D.C
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Telephone | 941-504-1792
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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 |
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