Provider Demographics
NPI:1588992390
Name:BRIAN D BRILL DC PLLC
Entity type:Organization
Organization Name:BRIAN D BRILL DC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BRILL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-278-1318
Mailing Address - Street 1:540 CARILLON PKWY
Mailing Address - Street 2:SUITE #2128
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1204
Mailing Address - Country:US
Mailing Address - Phone:727-278-1318
Mailing Address - Fax:
Practice Address - Street 1:5001 4TH ST N
Practice Address - Street 2:SUITE #2
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-2901
Practice Address - Country:US
Practice Address - Phone:727-278-1318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9753111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty