Provider Demographics
NPI:1255347134
Name:DURRIEU, DAN EUGENE (DC)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:EUGENE
Last Name:DURRIEU
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 1:5015 W WATERS AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1317
Mailing Address - Country:US
Mailing Address - Phone:813-882-8181
Mailing Address - Fax:813-882-3413
Practice Address - Street 1:5015 W WATERS AVE
Practice Address - Street 2:SUITE D
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-1317
Practice Address - Country:US
Practice Address - Phone:813-882-8181
Practice Address - Fax:813-882-3413
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7730111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3679Medicare ID - Type UnspecifiedCHIROPRACTIC