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General NPI Number Information
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NPI Number | 1801066097
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Entity Type | Organization
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Legal Business Name | LISA M KRAWCZUN DC PA
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 03/04/2008
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Provider Practice Location Address
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Address Line | 931 OAKFIELD DR
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City | BRANDON
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State | FL
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Zip | 33511-4935
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Country | US
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Telephone | 813-385-4442
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Fax |
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Provider Business Mailing Address
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Address Line | 902 VICTORIA ST
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City | BRANDON
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State | FL
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Zip | 33510-4107
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Country | US
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Telephone | 813-385-4442
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LISA M KRAWCZUN
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Credential | DO
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Telephone | 813-385-4442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH9011
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License Number State | FL
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