Provider Demographics
NPI:1316381734
Name:KERN, BRANDY LEE (DC)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:LEE
Last Name:KERN
Suffix:
Gender:F
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:PO BOX 691044
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32969-1044
Mailing Address - Country:US
Mailing Address - Phone:772-321-9581
Mailing Address - Fax:
Practice Address - Street 1:4777 CITY CENTER PKWY
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-4153
Practice Address - Country:US
Practice Address - Phone:772-321-9581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10658111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor