Provider Demographics
NPI:1891066494
Name:BRIAN SCOTT EDWARDS, D.C., P.A.
Entity Type:Organization
Organization Name:BRIAN SCOTT EDWARDS, D.C., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:754-300-6407
Mailing Address - Street 1:8197 N UNIVERSITY DR STE 3
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-1743
Mailing Address - Country:US
Mailing Address - Phone:754-300-6407
Mailing Address - Fax:954-944-0355
Practice Address - Street 1:8197 N UNIVERSITY DR STE 3
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-1743
Practice Address - Country:US
Practice Address - Phone:754-300-6407
Practice Address - Fax:954-944-0355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty