Provider Demographics
NPI:1043608185
Name:OSTRANDER, BRENT C (DC LLC)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:C
Last Name:OSTRANDER
Suffix:
Gender:M
Credentials:DC LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 48TH ST N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-4409
Mailing Address - Country:US
Mailing Address - Phone:727-686-5608
Mailing Address - Fax:727-525-7003
Practice Address - Street 1:7000 48TH ST N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-4409
Practice Address - Country:US
Practice Address - Phone:727-686-5608
Practice Address - Fax:727-525-7003
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-23
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11366111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor