Provider Demographics
NPI:1700944808
Name:BOOTH, ANNETTE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:
Last Name:BOOTH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:ANNETTE
Other - Middle Name:
Other - Last Name:MARTENSSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:717 GULF LAND DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-4844
Mailing Address - Country:US
Mailing Address - Phone:407-358-9526
Mailing Address - Fax:
Practice Address - Street 1:717 GULF LAND DR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-4844
Practice Address - Country:US
Practice Address - Phone:407-358-9526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7919111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor