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Organization
RADIANT HEALTH CHIROPRACTIC LLC
Active
Organization
RADIANT HEALTH CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON LAVELLE D.C. (CHIROPRACTOR)
(386) 308-9076
Entity
Organization
Contact information
Practice address
209 DUNLAWTON AVE STE 18, PORT ORANGE, FL 32127-4458
(386) 308-9076
(386) 675-6591
Mailing address
209 DUNLAWTON AVE STE 18, PORT ORANGE, FL 32127-4458
(386) 308-9076
(386) 675-6591
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH9993
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007930500
—
FL
Enumeration date
11/18/2011
Last updated
08/23/2021
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