Healthcare Provider Details

I. General information

NPI: 1306780283
Provider Name (Legal Business Name): BRANDON KENT HARRELL DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 LISENBY AVE
PANAMA CITY FL
32405-3585
US

IV. Provider business mailing address

900 CLARA AVE APT 1204
PANAMA CITY BEACH FL
32407-2945
US

V. Phone/Fax

Practice location:
  • Phone: 229-563-8857
  • Fax:
Mailing address:
  • Phone: 229-563-8857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH15581
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: