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General NPI Number Information
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NPI Number | 1720165889
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Entity Type | Organization
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Legal Business Name | DR JOHN PRO INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4370 S TAMIAMI TRL STE 235
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City | SARASOTA
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State | FL
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Zip | 34231-3414
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Country | US
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Telephone | 941-923-0907
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Fax | 941-923-4187
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Provider Business Mailing Address
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Address Line | 4816 WOOD POINTE WAY
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City | SARASOTA
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State | FL
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Zip | 34233-3526
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Country | US
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Telephone | 941-923-2090
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Fax | 941-923-4187
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN ALEXANDER PROKOPIAK
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Credential | D.C.
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Telephone | 941-923-0907
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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 | CH7143
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License Number State | FL
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