Provider Demographics
NPI:1174144422
Name:BRIAN DRUTMAN D.C., LLC
Entity type:Organization
Organization Name:BRIAN DRUTMAN D.C., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF LLC
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:DRUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-430-8834
Mailing Address - Street 1:5509 E LONGBOAT BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4220
Mailing Address - Country:US
Mailing Address - Phone:727-430-8834
Mailing Address - Fax:866-254-3787
Practice Address - Street 1:2529 W BUSCH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4546
Practice Address - Country:US
Practice Address - Phone:813-579-4047
Practice Address - Fax:866-254-3787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty