Provider Demographics
NPI:1649680927
Name:FORD, SAVANNAH IRBY (DC)
Entity type:Individual
Prefix:DR
First Name:SAVANNAH
Middle Name:IRBY
Last Name:FORD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SAVANNAH
Other - Middle Name:CATHERINE
Other - Last Name:IRBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:360 CENTRAL AVE
Mailing Address - Street 2:STE 480
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3857
Mailing Address - Country:US
Mailing Address - Phone:727-498-5643
Mailing Address - Fax:
Practice Address - Street 1:360 CENTRAL AVE
Practice Address - Street 2:STE 480
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3857
Practice Address - Country:US
Practice Address - Phone:727-498-5643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009312111N00000X
FLCH 11817111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor