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General NPI Number Information
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NPI Number | 1366630139
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Entity Type | Organization
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Legal Business Name | WESTCOAST SPINE CENTER SARASOTA PA
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 12/08/2011
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Provider Practice Location Address
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Address Line | 1217 S EAST AVE STE 304
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City | SARASOTA
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State | FL
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Zip | 34239-2352
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Country | US
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Telephone | 941-362-2000
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Fax | 941-362-9114
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Provider Business Mailing Address
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Address Line | 1217 S EAST AVE STE 304
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City | SARASOTA
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State | FL
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Zip | 34239-2352
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Country | US
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Telephone | 941-362-2000
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Fax | 941-362-9114
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CRAIG L BARCOMB
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Credential | DC
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Telephone | 941-362-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | CH0005461
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License Number State | FL
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