Provider Demographics
NPI:1225116601
Name:DRUTMAN, BRIAN CRAIG (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CRAIG
Last Name:DRUTMAN
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 1:5509 E LONGBOAT BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4220
Mailing Address - Country:US
Mailing Address - Phone:813-579-4047
Mailing Address - Fax:866-254-3787
Practice Address - Street 1:2529 W BUSCH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4546
Practice Address - Country:US
Practice Address - Phone:813-579-4047
Practice Address - Fax:866-254-3787
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8203111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor