Organization
SARASOTA WELLNESS AND WEIGHT MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLIFFORD LEE THACKER M.D. (OWNER)
(941) 388-7457
Entity
Organization
Contact information
Practice address
8588 POTTER PARK DR, ST 201, SARASOTA, FL 34238-5471
(941) 388-7457
(941) 256-3305
Mailing address
8588 POTTER PARK DR, ST 201, SARASOTA, FL 34238-5471
(941) 388-7457
(941) 256-3305
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
70754
FL
Other
Enumeration date
08/03/2012
Last updated
08/17/2012
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