Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH11702 | FL |
NPI | 1003270307 |
---|---|
Provider Name | Dr. Nancy M Bertelmann |
First Address | Lakeland, FL 33813-1543 |
Second Address | Lakeland, FL 33813-1543 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2016 |
Last Update Date | 12/04/2016 |