Organization
KENNETH W TRUSSELL DC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH W TRUSSELL DC (PRESIDENT/OWNER)
(813) 685-4222
Entity
Organization
Contact information
Practice address
113 W ROBERTSON ST, BRANDON, FL 33511-5111
(813) 685-4222
Mailing address
113 W ROBERTSON ST, BRANDON, FL 33511-5111
(813) 685-4222
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
6246
FL
Other
Enumeration date
09/27/2010
Last updated
09/27/2010
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