Provider Demographics
NPI:1376257634
Name:PECK, BRITTANY TAYLOR (DC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:TAYLOR
Last Name:PECK
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 1:403 JOAN AVE N
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-1941
Mailing Address - Country:US
Mailing Address - Phone:239-369-9109
Mailing Address - Fax:
Practice Address - Street 1:403 JOAN AVE N
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1941
Practice Address - Country:US
Practice Address - Phone:239-369-9109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13261111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor