MEDICARE: DR. BRIAN TIMOTHY HARCOURT DC FACO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NX0800X	Orthopedic Chiropractor	CH 9690	FL

General Provider Information

NPI Number	:	1558343459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN TIMOTHY HARCOURT DC FACO

Provider Business Mailing Address
First Line	:	7270 COLLEGE PKWY STE 2
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-5658
Country	:	US
Telephone Number	:	239-278-3344
Fax Number	:	239-278-3159

Provider Business Practice Location Address
First Line	:	7270 COLLEGE PKWY STE 2
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-5658
Country	:	US
Telephone Number	:	239-278-3344
Fax Number	:	239-278-3159

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	11/21/2011

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