Provider Demographics
NPI:1457470676
Name:ISBELL, BRYAN KEITH (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:KEITH
Last Name:ISBELL
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 1:257 W. BRANDO BLVD.
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5103
Mailing Address - Country:US
Mailing Address - Phone:813-685-1079
Mailing Address - Fax:813-681-7176
Practice Address - Street 1:257 W BRANDON BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5103
Practice Address - Country:US
Practice Address - Phone:813-685-1079
Practice Address - Fax:813-681-7176
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004943111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70601Medicare UPIN