Provider Demographics
NPI:1962593467
Name:DAHMER, BRIAN KURT (DC)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:KURT
Last Name:DAHMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9340 SOUTHERN CHARM CIR
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-6916
Mailing Address - Country:US
Mailing Address - Phone:352-683-7165
Mailing Address - Fax:727-862-8573
Practice Address - Street 1:9206 STATE ROAD 52
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34669-3029
Practice Address - Country:US
Practice Address - Phone:727-862-8571
Practice Address - Fax:727-862-8573
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9001111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor