Provider Demographics
NPI:1407897598
Name:BARTLETT, ERIC TAL (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:TAL
Last Name:BARTLETT
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 1:500 S MAITLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5622
Mailing Address - Country:US
Mailing Address - Phone:407-628-9999
Mailing Address - Fax:407-628-2917
Practice Address - Street 1:500 S MAITLAND AVE
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5622
Practice Address - Country:US
Practice Address - Phone:407-628-9999
Practice Address - Fax:407-628-2917
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9164111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor