Brandi Ancrum, DC
Individual provider Active NPI Chiropractor · Bartow, FL
NPI 1083071302 · NPPES record last updated Nov 21, 2016
Key facts
- NPI
- 1083071302
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CH11438 (FL)
- Practice address
- 680 E Main St
Ste 101
Bartow, FL 33830-4803 - Phone
- (863) 537-7330
- NPI assigned
- Jan 16, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH11438 | FL | Yes |
Addresses
Primary practice location
680 E Main St
Ste 101
Bartow, FL 33830-4803
Mailing address
680 E Main St
Ste 101
Bartow, FL 33830-4803
Phone (863) 537-7330
Other providers in Bartow, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.