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General NPI Number Information
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NPI Number | 1962299396
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Entity Type | Individual
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Provider Name | BRANDON CROWDIS
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Gender | Male
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 221 E 23RD ST
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City | PANAMA CITY
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State | FL
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Zip | 32405-7612
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Country | US
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Telephone | 850-215-1747
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Fax |
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Provider Business Mailing Address
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Address Line | 332 BLUE COVE DR APT 213
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-2682
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Country | US
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Telephone | 678-877-5134
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 15447
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License Number State | FL
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