Provider Demographics
NPI:1104174572
Name:BRYAN K ISBELL, D.C.P.A.
Entity type:Organization
Organization Name:BRYAN K ISBELL, D.C.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:ISBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-685-1079
Mailing Address - Street 1:257 W BRANDON BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5103
Mailing Address - Country:US
Mailing Address - Phone:813-685-1079
Mailing Address - Fax:
Practice Address - Street 1:257 W BRANDON BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5103
Practice Address - Country:US
Practice Address - Phone:813-685-1079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4943111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty