Individual
DANIELLE FORTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
6044 30TH AVE N, ST PETERSBURG, FL 33710-3334
(813) 360-6820
Mailing address
6044 30TH AVE N, ST PETERSBURG, FL 33710-3334
(813) 360-6820
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
12724
FL
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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