Organization
ADVANCED REJUVINATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN LIEURANCE DC (ADMINISTRATOR)
(941) 330-8553
Entity
Organization
Contact information
Practice address
2033 WOOD ST, SUITE 210, SARASOTA, FL 34237-7900
(941) 330-8553
(941) 330-9853
Mailing address
2033 WOOD ST, SUITE 210, SARASOTA, FL 34237-7900
(941) 330-8553
(941) 330-9853
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
CH7524
FL
171100000X
Acupuncturist
AP2975
FL
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
ME30555
FL
208D00000X
General Practice Physician
OS5165
FL
Other
Enumeration date
09/20/2012
Last updated
09/20/2012
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