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General NPI Number Information
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NPI Number | 1730728221
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Entity Type | Organization
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Legal Business Name | EAST OF 75 CHIROPRACTIC AND MEDICAL CARE
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Dates
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Enumeration Date | 12/31/2019
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Last Update Date | 12/31/2019
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Provider Practice Location Address
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Address Line | 40 SARASOTA CENTER BLVD. SUITE 103
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City | SARASOTA
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State | FL
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Zip | 34240-8758
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Country | US
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Telephone | 941-371-6824
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Fax |
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Provider Business Mailing Address
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Address Line | 40 SARASOTA CENTER BLVD. SUITE 103
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City | SARASOTA
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State | FL
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Zip | 34240-8758
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Country | US
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Telephone | 941-371-6824
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HOWARD R. VAN NOSTRAND
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Credential | D.C., B.S., B.A.
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Telephone | 941-371-6824
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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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